Anatomical location of the abducens nerves (VI) in the ventral approach of clival tumors

Abstract

The aim of this work was to determine reliable anatomical landmarks for locating and preserving the abducens nerves (6th cranial nerves) during trans-facial or trans-nasal endoscopic approaches of skull base tumors involving the clivus and the petrous apex. In order to describe this specific anatomy, we carefully dissected 10 cadaveric heads under optic magnification. Several measurements were taken between the two petro-sphénoidal foramina, from the bottom of the sella and the dorsum sellae. The close relationship between the nerves and the internal carotid artery were taken into account. We defined a trapezoid area that allowed drilling the clivus safely, preserving the 6th cranial nerve while being attentive to the internal carotid artery. The caudal part of this trapezium is, on average, 20 mm long at mi-distance between the two petro-sphenoidal foramina. The cranial part is at the sella level, a line between both paraclival internal carotid arteries. Oblique lateral edges between the cranial and caudal parts completed the trapezium.

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Acknowledgements

We would like to express our gratitude to all donors to the anatomy laboratory.

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VJ: project development, data collection, data analysis, manuscript writing and editing. MS: manuscript review of English spellings and grammatical errors. DL: protocol project development, data analysis.

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Correspondence to Vincent Jecko.

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Jecko, V., Sesay, M. & Liguoro, D. Anatomical location of the abducens nerves (VI) in the ventral approach of clival tumors. Surg Radiol Anat (2020). https://doi.org/10.1007/s00276-020-02525-4

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Keywords

  • Abducens nerve
  • Petrous apex
  • Petro-sphenoidal foramen
  • Anterior clival surgical approach