2025 Proffered Presentations
V090: THE TRANSPTERYGOID- TRANSMANDIBULAR STRUT- TRANSMEDIAL JUGULAR TUBERCLE INFERIOR TRANSPETROSAL ENDOSCOPIC ENDONASAL APPROACH AS A ROADMAP TO THE PARAPHARYNGEAL INTERNAL CAROTID ARTERY. CLINICAL CASE PRESENTATION AND OPERATIVE VIDEO.
Maria Karampouga, MD1; Liang Xa, MD, PhD1; Gregory J Varga, MS1; Eric Wang, MD2; Carl H Snyderman, MD, MBA2; Paul A Gardner, MD1; Garret W Choby, MD2; Georgios A Zenonos, MD1; 1Department of Neurological Surgery, Center for Cranial Base Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; 2Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
The parapharyngeal internal carotid artery (ppICA) lacks reliable landmarks from an endonasal perspective, making surgery in this region challenging. This video presents the clinical application of the transpterygoid- transmandibular strut- transmedial jugular tubercle inferior transpetrosal endoscopic endonasal approach as a roadmap to the ppICA. It concerns a case of nasopharyngeal carcinoma of the right Rosenmuller fossa whose resection entailed exposure of the paraclival and petrous carotid artery, that subsequently enabled safe dissection of the ppICA.