SUBTEMPORAL SUPRAPETRONS APPROACH TO THE HORIZONTAL PORTION OF THE PETROUS CAROTID-ARTERY - TECHNICAL NOTE, INDICATIONS

Cavernous sinus exploration, anterior middle fossa transpetrous approa ch, and saphenous vein graft bypass require proximal control of the ho rizontal segment of the petrous internal carotid artery. Exposing the petrous portion of the internal carotid artery is not without the pote ntial for serious complications (cochlea, facial nerve, auditory tube, musculus tensor tympani). With guidance from the classicaly landmarks within Glasscock's triangle, the bony petrous carotid canal can be un roofed. The authors describe an alternative method for obtaining direc t vascular control under the trigeminal ganglion, safety unroofing of the carotid canal and control of the posterior face of the carotid ben d. The indications, advantages, and disadvantages of this approach are described in details, along with its use in seven patients.