This study introduces expanded application of the endoscopic transcanal approach with anterior petrosectomy (ETAP) in reaching the petroclival region, which was compared through a quantitative analysis to the middle fossa transpetrosal-transtentorial approach (Kawase approach). Anatomical dissections were performed in five cadaveric heads. For each head, the ETAP was performed on one side with a detailed description of each step, while the Kawase approach was performed on the contralateral side. Quantitative measurements of the exposed area over the ventrolateral surface of the brainstem, and of the angles of attack to the posterior margin of the trigeminal nerve root entry zone (CN V-REZ) and porus acusticus internus (PAI) were obtained for statistical comparison. The ETAP provided significantly larger exposure over the ventrolateral surface of the pons (93.03 ± 21.87 mm²) than did the Kawase approach (34.57 ± 11.78 mm²). In contrast to the ETAP, the Kawase approach afforded greater angles of attack to the CN V-REZ and PAI in the vertical and horizontal planes. The ETAP is a feasible and minimally invasive procedure for accessing the petroclival region. In comparison to the Kawase approach, the ETAP allows for fully anterior petrosectomy and larger exposure over the ventrolateral surface of the brainstem without passing through the cranial nerves or requiring traction of the temporal lobe.

本研究介绍了内窥镜经颅骨前路切除术 (ETAP) 在到达岩斜区的扩展应用，并通过定量分析将其与中颅窝经小脑幕入路 (Kawase 入路) 进行了比较。在五个尸体头部进行解剖解剖。对于每个头部，在一侧进行 ETAP 并详细描述每个步骤，而在对侧进行 Kawase 入路。获得了脑干腹外侧表面暴露面积的定量测量值，以及三叉神经根进入区 (CN V-REZ) 和耳内孔 (PAI) 后缘的攻角，用于统计比较。² ) 比 Kawase 方法 (34.57 ± 11.78 mm ² )。与 ETAP 相比，Kawase 方法在垂直和水平平面上为 CN V-REZ 和 PAI 提供了更大的攻角。ETAP 是一种可行的微创手术，用于进入岩斜区。与 Kawase 入路相比，ETAP 允许完全前岩切除术和脑干腹外侧表面的更大暴露，而无需穿过颅神经或需要牵引颞叶。