SURGICAL EXPOSURE OF THE PETROUS INTERNAL CAROTID-ARTERY - PRACTICAL APPLICATION FOR SKULL BASE SURGERY

When exposing the horizontal petrous carotid artery in preparation for intrapetrous carotid bypass, the surgeon has no definite landmarks to localize the perimeter of the cochlea. The results of this study prov ide a practical, consistent, and safe method to maximize carotid arter y exposure while minimizing cochlear injury. We measured the carotid-c ochlea distance (mean, 4.3 mm) and the carotid-cochlear angle (mean, 1 0.8 degrees) in 33 temporal bones in which the extended middle fossa a pproach had been performed. We correlated this distance to the width o f a Sheehy weapon knife, which can be easily measured intraoperatively . Twenty-five temporal bones were imaged prior to surgical exposure us ing a new computed tomography (CT) protocol that can be used for preop erative assessment of the carotid-cochlear anatomy, The carotid-cochle a distance and carotid-cochlear angle measured on CT are compared with postsurgical measurements.