gms | German Medical Science

Background: Injury to the internal carotid artery (ICA) in the endoscopic endonasal skull base surgery is a catastrophic complication.

Objective: To avoid the injury to the internal carotid artery, to report the anatomy of endoscopic approach to the carotid, identify potential risk factors, and present management.

Methods: We performed endoscopic carotid cadaver dissection in 10 fresh head, and performed a retrospective review of all endoscopic endonasal skull base surgery that performed at our institution between 2010-2016, to evaluate the internal carotid injury in the surgery.

Results: Surgical landmarks included the Eustachian tube, the fossa of Rosenmuller, and levator veli palatine, the vidian canal, foramen rotundum, foramen avale. There were 5 ICA injuries encountered in our series of surgery. The diagnosis of patients with carotid injuries were chordoma, chondrosarcoma, neurofibroma, pituitary adenoma and meningioma respectively. There were no intraoperative and postoperative mortality; 2 of the 5 patients developed a pseudoaneurysm in the follow-up period, which was treated endovascularly, and one patient suffered a short-time stroke that recover in one month.

Conclusion: ICA injury in the skull base surgery is a rare, feared and manageable complication. Proper protection of carotid in the surgery is most important method. Appropriate management of the carotid injury may avoid a disastrous events.

Unterstützt durch: Department of ENT , Eye and ENT Hospital, Fudan University. Shanghai, CHINA

Der Erstautor gibt keinen Interessenkonflikt an.