Microsurgical Anatomy of the Pterygosphenoidal Triangle: Implication in Endoscopic Endonasal Skull Base Surgery

Objective: The foramen lacerum is a key landmark in endoscopic endonasal approaches. Several skull base lesions may involve the foramen lacerum region, most typically chondrosarcomas, but also pathologies affecting the cavernous sinus, Meckel's cave, petrous apex, clivus, nasopharynx, eustachian tube, and jugular foramen. Safe exposure of the lacerum segment of the carotid artery remains a challenge in endoscopic endonasal surgery. In our previous study, the surgical anatomy of the foramen lacerum was investigated; here we continue to propose a novel and reliable landmark, the pterygosphenoidal triangle, to facilitate access in endoscopic endonasal translacerum approach.