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Surgical Anatomy of Surgical Anatomy of

Surgical Anatomy of - PowerPoint Presentation

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Surgical Anatomy of - PPT Presentation

Skull Base Dr Supreet Singh Nayyar AFMC For more presentations visit wwwnayyarENTcom wwwnayyarENTcom 1 Topography of Skull Base Boundaries Anterior Incisors upper teeth ID: 136496

www nayyarent base foramen nayyarent www foramen base nerve skull artery canal area fossa amp anterior branch anatomy inferior

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Slide1

Surgical Anatomy of Skull Base

Dr. Supreet Singh Nayyar, AFMCFor more presentations, visit www.nayyarENT.com

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1Slide2

Topography of Skull Base

Boundaries : Anterior : Incisors upper teeth Posterior: Superior nuchal line

Lateral : Upper lateral teeth

Zygomatic

arch Mastoid process

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2Slide3

Anterior Skull Base

Central Skull Base

Posterior Skull Base

Topography of Skull Base

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3Slide4

Skull Base Anatomy Review

Key Openings

Foramen spinosum

Foramen ovale

Foramen lacerum

Foramen rotundum

Foramen magnum

Foramen of vesalius

Jugular foramen

Superior orbital fissure

Inferior orbital fissure

Optic canal

Vidian canal

Hypoglossal canal

Pterygopalatine fossa

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4Slide5

Skull Base Anatomy Review

Foramen magnum

Medulla oblongata

Vertebral arteries

Anterior/Posterior spinal arteries

Hypoglossal canal

Hypoglossal nerve

Hypoglossal artery

Jugular Foramen

Pars nervosa: CN IX, inferior petrosal sinus

Pars vascularis: CN X, XI, jugular bulb

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5Slide6

Skull Base Anatomy Review

Foramen Spinosum

Middle meningeal artery

Recurrent branch of mandibular nerve

Foramen Ovale

Mandibular nerve

Accessory meningeal artery

Lesser petrosal nerve

Emissary veins

Foramen of Vesalius

Sphenoidal Emissary vein

Stylomastoid foramen

Facial nerve

Stylomastoid artery

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6Slide7

Skull Base Anatomy Review

Foramen Lacerum

Ascending pharyngeal artery- meningeal branch

Nerve of pterygoid canal

Pterygoid canal

Vidian nerve

Vidian artery

Foramen rotundum

Maxillary nerve

Artery of foramen rotundum

Emissary veins

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7Slide8

Receives: Superior opthalmic vein Inferior opthalmic vein Sphenoparietal sinus

Drains via: Petrosal sinuses Basilar plexus Pterygoid plexus

Connection: Circular sinus

Contains: CN III, IV, V

1

, V

2,

VI

Skull Base Anatomy Review

Cavernous Sinus

Meckel’s Cave

Posterior aspect of cavernous sinus

Gasserian ganglion (sensory root ganglion of CN V)

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8Slide9

Skull Base Anatomy Review

Superior Orbital Fissure

CN III, IV, V

1

, VI

Middle meningeal artery- orbital branch

Recurrent meningeal artery

Superior ophthalmic vein

Inferior Orbital Fissure

Infraorbital artery, vein, and nerve (V

2

branch)

Optic Canal

Optic nerve

Ophthalmic artery

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9Slide10

Central Skull Base

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Central Skull Base

1www.nayyarENT.com11

1

2

3

6

5

4

1- Pharyngeal Area

2- Tubal Area

3- Neurovascular Area

4- Auditory Area

5- Articular Area

6-

Infratemporal

FossSlide12

Pharyngeal Area

Roof of Nasopharynx Boundaries of Nasopharynx : * Anterior

* Lateral & Posterior * Inferior

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12Slide13

Pharyngeal Area

Pharyngobasilar fasia Fossa of Rosenmullar * Location- above &

behind medial end ET

* Depth- 2.5 cm

* Apex- Carotid canal

opening (post) & f. ovale, f. spinosum

(lat) * Base- below

Foramen lacerum

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13Slide14

Tubal Area

Eustachian Tube Scaphoid fossa Runs b/w petrous bone & greater wing

sphenoid Opening- nasopharynx

Paratubal muscles

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14Slide15

Neurovascular Area

Important structures are: Carotid sheath & its contents Styloid apparatus

Facial Nerve

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15Slide16

Carotid Sheath

Compact network of aerolar tissue Carotid canal to arch of aorta

Encloses : ICA above & CCA below

IJV

Vagus nerve

Carotid Canal : ICA & Carotid plexus

sympathetic nerve

Parts of ICA

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16Slide17

Divided into three compartments

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Jugular Foramen

Compartments

Contents ( lateral

to medial )

Anterior

* IX Nerve

* Inferior petrosal

Sinus

Middle

* XI Nerve

* X Nerve

Posterior

* IJVSlide18

Styloid Apparatus

Bone- Styloid bone

Ligaments- * Stylohyoid * Stylomandibular

Muscles- * Stylohoid

* Stylopharyngeus

* Styloglossus

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18Slide19

Facial Nerve

Arise from Stylomastoid Foramen Branches: i) Post auricular nerve ii) Digastric branch

iii) Temporofacial branch iv) Cervicofacial branch

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19Slide20

Auditory Area

Petrotympanic fissure of Glaser: * Chorda tympani * Ant br of

tympanic artery

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20Slide21

Infratemporal Fossa

Location : below middle cranial fossa Boundaries

Contents: * Med & Lat Pterygoid M

* Maxillary A

* Maxillary V

* Pterygoid Venous Plexus * Br of Mandibular N

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21Slide22

Pterygopalatine Fossa

Small inverted pyramid shaped fossa Location

Boundaries

Communications

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22Slide23

Anterior Cranial Base

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Anterior Cranial Base from inside

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24Slide25

Floor of Anterior Cranial Fossa

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25

Depth of Olfactory

fossa (Keros classification)

* Type I – 1-3mm

* Type II- 4-7mm

* Type III- 8-17mmSlide26

Thank you

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