Biomaterial Database

Microsurgical exposure of the petrous portion of the carotid artery. 1977

W S Paullus, and T G Pait, and A I Rhoton

Occlusion of the cervical portion of the internal carotid artery (ICA) has been treated by vein graft bypass from the common carotid to the supraclinoid segment. However, this procedure has the disadvantages of requiring temporary occlusion of collateral flow, the short length of ICA available for anastomosis, and the retraction required for exposure of the supraclinoid area. In an attempt to find a more suitable bypass site for grafting, the petrous portion of 50 carotid arteries was studied in cadavers. It was found that there was a 1-cm length of the horizontal segment of the petrous carotid that could be exposed in the floor of the middle fossa lateral to the trigeminal nerve. This segment was covered by dura only or a thin layer of cartilage in approximately half of the specimens. In the remainder, there was often a thin shell of bone covering the artery, which could be drilled away. The petrous portion of the carotid artery had branches in only 38% of specimens, a Vidian branch in 30%, and a periosteal branch in 8%. The carotico-tympanic artery, previously reported to be the most common branch, was not found in a single case. These branches allow the retrograde flow needed to maintain the patency of this segment following proximal occlusions. The relationship of the carotid artery to structures include the cochlea, middle ear, Eustachian tube, tensor tympani muscle, geniculate ganglion, and facial, greater petrosal, and trigminal nerves.

UI	MeSH Term	Description	Entries
D008866	Microsurgery	The performance of surgical procedures with the aid of a microscope.
D010579	Petrous Bone	The dense rock-like part of temporal bone that contains the INNER EAR. Petrous bone is located at the base of the skull. Sometimes it is combined with the MASTOID PROCESS and called petromastoid part of temporal bone.	Petrous Apex,Petrous Pyramid,Bone, Petrous,Petrous Bones
D002343	Carotid Artery, Internal	Branch of the common carotid artery which supplies the anterior part of the brain, the eye and its appendages, the forehead and nose.	Arteries, Internal Carotid,Artery, Internal Carotid,Carotid Arteries, Internal,Internal Carotid Arteries,Internal Carotid Artery
D003051	Cochlea	The part of the inner ear (LABYRINTH) that is concerned with hearing. It forms the anterior part of the labyrinth, as a snail-like structure that is situated almost horizontally anterior to the VESTIBULAR LABYRINTH.	Cochleas
D004432	Ear, Middle	The space and structures directly internal to the TYMPANIC MEMBRANE and external to the inner ear (LABYRINTH). Its major components include the AUDITORY OSSICLES and the EUSTACHIAN TUBE that connects the cavity of middle ear (tympanic cavity) to the upper part of the throat.	Tympanic Cavity,Tympanum,Middle Ear,Cavities, Tympanic,Cavity, Tympanic,Ears, Middle,Middle Ears,Tympanic Cavities,Tympanums
D005064	Eustachian Tube	A narrow passageway that connects the upper part of the throat to the TYMPANIC CAVITY.	Auditory Tube,Pharyngotympanic Tube,Auditory Tubes,Eustachian Tubes,Pharyngotympanic Tubes,Tube, Auditory,Tube, Eustachian,Tube, Pharyngotympanic,Tubes, Auditory,Tubes, Eustachian,Tubes, Pharyngotympanic
D005154	Facial Nerve	The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and SALIVARY GLANDS, and convey afferent information for TASTE from the anterior two-thirds of the TONGUE and for TOUCH from the EXTERNAL EAR.	Cranial Nerve VII,Marginal Mandibular Branch,Marginal Mandibular Nerve,Seventh Cranial Nerve,Nerve VII,Nerve of Wrisberg,Nervus Facialis,Nervus Intermedius,Nervus Intermedius of Wrisberg,Cranial Nerve VIIs,Cranial Nerve, Seventh,Facial Nerves,Mandibular Nerve, Marginal,Mandibular Nerves, Marginal,Marginal Mandibular Nerves,Nerve VIIs,Nerve, Facial,Nerve, Marginal Mandibular,Nerve, Seventh Cranial,Nerves, Marginal Mandibular,Nervus Faciali,Seventh Cranial Nerves,Wrisberg Nerve,Wrisberg Nervus Intermedius
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014276	Trigeminal Nerve	The 5th and largest cranial nerve. The trigeminal nerve is a mixed motor and sensory nerve. The larger sensory part forms the ophthalmic, mandibular, and maxillary nerves which carry afferents sensitive to external or internal stimuli from the skin, muscles, and joints of the face and mouth and from the teeth. Most of these fibers originate from cells of the TRIGEMINAL GANGLION and project to the TRIGEMINAL NUCLEUS of the brain stem. The smaller motor part arises from the brain stem trigeminal motor nucleus and innervates the muscles of mastication.	Cranial Nerve V,Fifth Cranial Nerve,Nerve V,Nervus Trigeminus,Cranial Nerve, Fifth,Fifth Cranial Nerves,Nerve V, Cranial,Nerve Vs,Nerve, Fifth Cranial,Nerve, Trigeminal,Trigeminal Nerves,Trigeminus, Nervus