title: Eustachian Tube as a Landmark to the Internal Carotid Artery in Endoscopic Skull Base Surgery.
abstract: OBJECTIVE
  The purpose of this study was to probe the relationship between the eustachian tube and the internal carotid artery in skull base surgery by an intranasal endoscopic approach.
  
  
  METHODS
  Cadaver study and illustrative cases.
  
  
  METHODS
  Minimally invasive surgery laboratory and operating room.
  
  
  METHODS
  A series of 5 cadaveric heads were dissected to elaborate on the relevant surgical anatomy about the eustachian tube and the internal carotid artery. Three cases were presented to illustrate the application of our laboratory findings.
  
  
  RESULTS
  The bony-cartilaginous junction of the eustachian tube was just anterior to the first genu of the internal carotid artery by an intranasal endoscopic approach. The 3 patients in our study tolerated the procedure well and experienced no serious complications after surgery.
  
  
  CONCLUSIONS
  The anatomic data and clinical cases in this study confirmed that the eustachian tube is a consistent and reliable landmark to the internal carotid artery to avoid its injury in skull base surgery through the endoscopic endonasal route.
authors.affiliation: Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, People's Republic of China.
authors.forename: Juan
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, People's Republic of China.
authors.forename: Xicai
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, People's Republic of China.
authors.forename: Quan
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, People's Republic of China wang_dehuient@126.com.
authors.forename: Dehui
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, People's Republic of China.
authors.forename: Huan
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, People's Republic of China.
authors.forename: Na
authors.initials: N
authors.lastname: Ma
mesh_terms: D059925:Anatomic Landmarks; D002102:Cadaver; D002343:Carotid Artery, Internal / Q000033:anatomy & histology*; D005064:Eustachian Tube / Q000033:anatomy & histology*; D006801:Humans; D008866:Microsurgery; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D009666:Nose; D019291:Skull Base / Q000601:surgery*
keywords: endoscopic endonasal approach; eustachian tube; internal carotid artery; skull base; surgery; vidian canal