char = [;code = 91 char = S;code = 83 char = u;code = 117 char = r;code = 114 char = g;code = 103 char = i;code = 105 char = c;code = 99 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = a;code = 97 char = p;code = 112 char = p;code = 112 char = r;code = 114 char = o;code = 111 char = a;code = 97 char = c;code = 99 char = h;code = 104 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = p;code = 112 char = e;code = 101 char = t;code = 116 char = r;code = 114 char = o;code = 111 char = u;code = 117 char = s;code = 115 char = ;code = 32 char = v;code = 118 char = e;code = 101 char = r;code = 114 char = t;code = 116 char = i;code = 105 char = c;code = 99 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = s;code = 115 char = e;code = 101 char = g;code = 103 char = m;code = 109 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = u;code = 117 char = p;code = 112 char = p;code = 112 char = e;code = 101 char = r;code = 114 char = ;code = 32 char = c;code = 99 char = e;code = 101 char = r;code = 114 char = v;code = 118 char = i;code = 105 char = c;code = 99 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = n;code = 110 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = c;code = 99 char = a;code = 97 char = r;code = 114 char = o;code = 111 char = t;code = 116 char = i;code = 105 char = d;code = 100 char = ];code = 93 char = .;code = 46 result sql = [Surgical approach of the petrous vertical segment and upper cervical internal carotid].
[Surgical approach of the petrous vertical segment and upper cervical internal carotid].char = T;code = 84 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = m;code = 109 char = a;code = 97 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = o;code = 111 char = b;code = 98 char = s;code = 115 char = t;code = 116 char = a;code = 97 char = c;code = 99 char = l;code = 108 char = e;code = 101 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = ;code = 32 char = s;code = 115 char = u;code = 117 char = c;code = 99 char = c;code = 99 char = e;code = 101 char = s;code = 115 char = s;code = 115 char = f;code = 102 char = u;code = 117 char = l;code = 108 char = ;code = 32 char = m;code = 109 char = a;code = 97 char = n;code = 110 char = a;code = 97 char = g;code = 103 char = e;code = 101 char = m;code = 109 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = e;code = 101 char = u;code = 117 char = r;code = 114 char = y;code = 121 char = s;code = 115 char = m;code = 109 char = s;code = 115 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = v;code = 118 char = o;code = 111 char = l;code = 108 char = v;code = 118 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = h;code = 104 char = i;code = 105 char = g;code = 103 char = h;code = 104 char = ;code = 32 char = c;code = 99 char = e;code = 101 char = r;code = 114 char = v;code = 118 char = i;code = 105 char = c;code = 99 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = n;code = 110 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = c;code = 99 char = a;code = 97 char = r;code = 114 char = o;code = 111 char = t;code = 116 char = i;code = 105 char = d;code = 100 char = ;code = 32 char = a;code = 97 char = r;code = 114 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = y;code = 121 char = ;code = 32 char = (;code = 40 char = I;code = 73 char = C;code = 67 char = A;code = 65 char = );code = 41 char = ;code = 32 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = ;code = 32 char = o;code = 111 char = b;code = 98 char = t;code = 116 char = a;code = 97 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = ;code = 32 char = a;code = 97 char = d;code = 100 char = e;code = 101 char = q;code = 113 char = u;code = 117 char = a;code = 97 char = t;code = 116 char = e;code = 101 char = ;code = 32 char = e;code = 101 char = x;code = 120 char = p;code = 112 char = o;code = 111 char = s;code = 115 char = u;code = 117 char = r;code = 114 char = e;code = 101 char = .;code = 46 char = ;code = 32 char = I;code = 73 char = n;code = 110 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = r;code = 114 char = e;code = 101 char = p;code = 112 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = ;code = 32 char = w;code = 119 char = e;code = 101 char = ;code = 32 char = d;code = 100 char = e;code = 101 char = s;code = 115 char = c;code = 99 char = r;code = 114 char = i;code = 105 char = b;code = 98 char = e;code = 101 char = ;code = 32 char = o;code = 111 char = u;code = 117 char = r;code = 114 char = ;code = 32 char = e;code = 101 char = x;code = 120 char = p;code = 112 char = e;code = 101 char = r;code = 114 char = i;code = 105 char = e;code = 101 char = n;code = 110 char = c;code = 99 char = e;code = 101 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = 5;code = 53 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = s;code = 115 char = ;code = 32 char = p;code = 112 char = r;code = 114 char = e;code = 101 char = s;code = 115 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = c;code = 99 char = a;code = 97 char = r;code = 114 char = o;code = 111 char = t;code = 116 char = i;code = 105 char = d;code = 100 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = e;code = 101 char = u;code = 117 char = r;code = 114 char = y;code = 121 char = s;code = 115 char = m;code = 109 char = s;code = 115 char = ;code = 32 char = a;code = 97 char = t;code = 116 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = s;code = 115 char = k;code = 107 char = u;code = 117 char = l;code = 108 char = l;code = 108 char = ;code = 32 char = b;code = 98 char = a;code = 97 char = s;code = 115 char = e;code = 101 char = ,;code = 44 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = m;code = 109 char = e;code = 101 char = d;code = 100 char = i;code = 105 char = a;code = 97 char = t;code = 116 char = e;code = 101 char = l;code = 108 char = y;code = 121 char = ;code = 32 char = b;code = 98 char = e;code = 101 char = l;code = 108 char = o;code = 111 char = w;code = 119 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = c;code = 99 char = a;code = 97 char = r;code = 114 char = o;code = 111 char = t;code = 116 char = i;code = 105 char = d;code = 100 char = ;code = 32 char = f;code = 102 char = o;code = 111 char = r;code = 114 char = a;code = 97 char = m;code = 109 char = e;code = 101 char = n;code = 110 char = .;code = 46 char = ;code = 32 char = E;code = 69 char = x;code = 120 char = p;code = 112 char = o;code = 111 char = s;code = 115 char = u;code = 117 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = a;code = 97 char = c;code = 99 char = h;code = 104 char = i;code = 105 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = t;code = 116 char = w;code = 119 char = o;code = 111 char = ;code = 32 char = s;code = 115 char = t;code = 116 char = a;code = 97 char = g;code = 103 char = e;code = 101 char = s;code = 115 char = .;code = 46 char = ;code = 32 char = T;code = 84 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = c;code = 99 char = e;code = 101 char = r;code = 114 char = v;code = 118 char = i;code = 105 char = c;code = 99 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = s;code = 115 char = t;code = 116 char = a;code = 97 char = g;code = 103 char = e;code = 101 char = ;code = 32 char = c;code = 99 char = o;code = 111 char = n;code = 110 char = s;code = 115 char = i;code = 105 char = s;code = 115 char = t;code = 116 char = s;code = 115 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = r;code = 114 char = e;code = 101 char = s;code = 115 char = e;code = 101 char = c;code = 99 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = s;code = 115 char = t;code = 116 char = y;code = 121 char = l;code = 108 char = o;code = 111 char = i;code = 105 char = d;code = 100 char = ;code = 32 char = p;code = 112 char = r;code = 114 char = o;code = 111 char = c;code = 99 char = e;code = 101 char = s;code = 115 char = s;code = 115 char = e;code = 101 char = s;code = 115 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = m;code = 109 char = u;code = 117 char = s;code = 115 char = c;code = 99 char = l;code = 108 char = e;code = 101 char = s;code = 115 char = ;code = 32 char = f;code = 102 char = o;code = 111 char = l;code = 108 char = l;code = 108 char = o;code = 111 char = w;code = 119 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = b;code = 98 char = y;code = 121 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = i;code = 105 char = o;code = 111 char = r;code = 114 char = ;code = 32 char = d;code = 100 char = i;code = 105 char = s;code = 115 char = p;code = 112 char = l;code = 108 char = a;code = 97 char = c;code = 99 char = e;code = 101 char = m;code = 109 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = m;code = 109 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = i;code = 105 char = b;code = 98 char = u;code = 117 char = l;code = 108 char = a;code = 97 char = r;code = 114 char = ;code = 32 char = c;code = 99 char = o;code = 111 char = n;code = 110 char = d;code = 100 char = y;code = 121 char = l;code = 108 char = e;code = 101 char = .;code = 46 char = ;code = 32 char = T;code = 84 char = h;code = 104 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = e;code = 101 char = x;code = 120 char = p;code = 112 char = o;code = 111 char = s;code = 115 char = e;code = 101 char = s;code = 115 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = v;code = 118 char = e;code = 101 char = r;code = 114 char = t;code = 116 char = i;code = 105 char = c;code = 99 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = s;code = 115 char = e;code = 101 char = g;code = 103 char = m;code = 109 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = p;code = 112 char = e;code = 101 char = t;code = 116 char = r;code = 114 char = o;code = 111 char = u;code = 117 char = s;code = 115 char = ;code = 32 char = I;code = 73 char = C;code = 67 char = A;code = 65 char = .;code = 46 char = ;code = 32 char = T;code = 84 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = p;code = 112 char = e;code = 101 char = t;code = 116 char = r;code = 114 char = o;code = 111 char = u;code = 117 char = s;code = 115 char = ;code = 32 char = s;code = 115 char = t;code = 116 char = a;code = 97 char = g;code = 103 char = e;code = 101 char = ;code = 32 char = c;code = 99 char = o;code = 111 char = n;code = 110 char = s;code = 115 char = i;code = 105 char = s;code = 115 char = t;code = 116 char = s;code = 115 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = r;code = 114 char = t;code = 116 char = i;code = 105 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = p;code = 112 char = e;code = 101 char = t;code = 116 char = r;code = 114 char = e;code = 101 char = c;code = 99 char = t;code = 116 char = o;code = 111 char = m;code = 109 char = y;code = 121 char = ;code = 32 char = e;code = 101 char = x;code = 120 char = p;code = 112 char = o;code = 111 char = s;code = 115 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = j;code = 106 char = u;code = 117 char = g;code = 103 char = u;code = 117 char = l;code = 108 char = a;code = 97 char = r;code = 114 char = ;code = 32 char = b;code = 98 char = u;code = 117 char = l;code = 108 char = b;code = 98 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = i;code = 105 char = r;code = 114 char = d;code = 100 char = ;code = 32 char = s;code = 115 char = e;code = 101 char = g;code = 103 char = m;code = 109 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = f;code = 102 char = a;code = 97 char = c;code = 99 char = i;code = 105 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = n;code = 110 char = e;code = 101 char = r;code = 114 char = v;code = 118 char = e;code = 101 char = .;code = 46 char = ;code = 32 char = U;code = 85 char = s;code = 115 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = r;code = 114 char = o;code = 111 char = u;code = 117 char = t;code = 116 char = e;code = 101 char = ,;code = 44 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = v;code = 118 char = e;code = 101 char = r;code = 114 char = t;code = 116 char = i;code = 105 char = c;code = 99 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = t;code = 116 char = r;code = 114 char = a;code = 97 char = p;code = 112 char = e;code = 101 char = t;code = 116 char = r;code = 114 char = o;code = 111 char = u;code = 117 char = s;code = 115 char = ;code = 32 char = s;code = 115 char = e;code = 101 char = g;code = 103 char = m;code = 109 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = I;code = 73 char = C;code = 67 char = A;code = 65 char = ;code = 32 char = c;code = 99 char = a;code = 97 char = n;code = 110 char = ;code = 32 char = b;code = 98 char = e;code = 101 char = ;code = 32 char = d;code = 100 char = r;code = 114 char = i;code = 105 char = l;code = 108 char = l;code = 108 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = a;code = 97 char = w;code = 119 char = a;code = 97 char = y;code = 121 char = ;code = 32 char = w;code = 119 char = i;code = 105 char = t;code = 116 char = h;code = 104 char = o;code = 111 char = u;code = 117 char = t;code = 116 char = ;code = 32 char = d;code = 100 char = a;code = 97 char = m;code = 109 char = a;code = 97 char = g;code = 103 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = m;code = 109 char = i;code = 105 char = d;code = 100 char = d;code = 100 char = l;code = 108 char = e;code = 101 char = ;code = 32 char = e;code = 101 char = a;code = 97 char = r;code = 114 char = .;code = 46 char = ;code = 32 char = I;code = 73 char = n;code = 110 char = ;code = 32 char = o;code = 111 char = u;code = 117 char = r;code = 114 char = ;code = 32 char = s;code = 115 char = e;code = 101 char = r;code = 114 char = i;code = 105 char = e;code = 101 char = s;code = 115 char = ,;code = 44 char = ;code = 32 char = n;code = 110 char = o;code = 111 char = ;code = 32 char = v;code = 118 char = a;code = 97 char = s;code = 115 char = c;code = 99 char = u;code = 117 char = l;code = 108 char = a;code = 97 char = r;code = 114 char = ;code = 32 char = c;code = 99 char = o;code = 111 char = m;code = 109 char = p;code = 112 char = l;code = 108 char = i;code = 105 char = c;code = 99 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = s;code = 115 char = ;code = 32 char = o;code = 111 char = c;code = 99 char = c;code = 99 char = u;code = 117 char = r;code = 114 char = r;code = 114 char = e;code = 101 char = d;code = 100 char = .;code = 46 char = ;code = 32 char = D;code = 68 char = a;code = 97 char = m;code = 109 char = a;code = 97 char = g;code = 103 char = e;code = 101 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = v;code = 118 char = o;code = 111 char = l;code = 108 char = v;code = 118 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = f;code = 102 char = a;code = 97 char = c;code = 99 char = i;code = 105 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = g;code = 103 char = l;code = 108 char = o;code = 111 char = s;code = 115 char = s;code = 115 char = o;code = 111 char = p;code = 112 char = h;code = 104 char = a;code = 97 char = r;code = 114 char = y;code = 121 char = n;code = 110 char = g;code = 103 char = e;code = 101 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = v;code = 118 char = a;code = 97 char = g;code = 103 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = n;code = 110 char = e;code = 101 char = r;code = 114 char = v;code = 118 char = e;code = 101 char = s;code = 115 char = ;code = 32 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = d;code = 100 char = i;code = 105 char = s;code = 115 char = c;code = 99 char = u;code = 117 char = s;code = 115 char = s;code = 115 char = e;code = 101 char = d;code = 100 char = .;code = 46 char = ;code = 32 char = T;code = 84 char = h;code = 104 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = a;code = 97 char = p;code = 112 char = p;code = 112 char = r;code = 114 char = o;code = 111 char = a;code = 97 char = c;code = 99 char = h;code = 104 char = ;code = 32 char = a;code = 97 char = p;code = 112 char = p;code = 112 char = e;code = 101 char = a;code = 97 char = r;code = 114 char = s;code = 115 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = ;code = 32 char = b;code = 98 char = e;code = 101 char = ;code = 32 char = a;code = 97 char = ;code = 32 char = s;code = 115 char = u;code = 117 char = i;code = 105 char = t;code = 116 char = a;code = 97 char = b;code = 98 char = l;code = 108 char = e;code = 101 char = ;code = 32 char = a;code = 97 char = l;code = 108 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = n;code = 110 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = v;code = 118 char = e;code = 101 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = c;code = 99 char = o;code = 111 char = n;code = 110 char = v;code = 118 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = f;code = 102 char = r;code = 114 char = a;code = 97 char = t;code = 116 char = e;code = 101 char = m;code = 109 char = p;code = 112 char = o;code = 111 char = r;code = 114 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = a;code = 97 char = p;code = 112 char = p;code = 112 char = r;code = 114 char = o;code = 111 char = a;code = 97 char = c;code = 99 char = h;code = 104 char = ;code = 32 char = w;code = 119 char = h;code = 104 char = i;code = 105 char = c;code = 99 char = h;code = 104 char = ;code = 32 char = s;code = 115 char = a;code = 97 char = c;code = 99 char = r;code = 114 char = i;code = 105 char = f;code = 102 char = i;code = 105 char = c;code = 99 char = e;code = 101 char = s;code = 115 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = m;code = 109 char = i;code = 105 char = d;code = 100 char = d;code = 100 char = l;code = 108 char = e;code = 101 char = ;code = 32 char = e;code = 101 char = a;code = 97 char = r;code = 114 char = .;code = 46 char = <;code = 60 char = b;code = 98 char = r;code = 114 char = /;code = 47 char = >;code = 62 result sql = The main obstacle to successful management of aneurysms involving the high cervical internal carotid artery (ICA) is to obtain an adequate exposure. In this report we describe our experience in 5 patients presenting carotid aneurysms at the skull base, intermediately below the carotid foramen. Exposure is achieved in two stages. The cervical stage consists in resection of the styloid processes and muscles followed by anterior displacement of the mandibular condyle. This exposes the vertical segment of the petrous ICA. The petrous stage consists in partial petrectomy exposing the jugular bulb and the third segment of the facial nerve. Using this route, the vertical intrapetrous segment of the ICA can be drilled away without damaging the middle ear. In our series, no vascular complications occurred. Damage involving the facial glossopharyngeal and vagal nerves is discussed. This approach appears to be a suitable alternative to the conventional infratemporal approach which sacrifices the middle ear.
Publication: Ann Otolaryngol Chir Cervicofac 1994 ;111(4)::211-6.
Publication Date: 1994
Study Author(s): Zanaret, M;Giovanni, A;Cannoni, M;Pech, A;Piquet, P;Branchereau, A;Mercier, C;
Institution: Département ORL, CHU Timone, F 13385 Marseille.
Shortcut link to this study:
The main obstacle to successful management of aneurysms involving the high cervical internal carotid artery (ICA) is to obtain an adequate exposure. In this report we describe our experience in 5 patients presenting carotid aneurysms at the skull base, intermediately below the carotid foramen. Exposure is achieved in two stages. The cervical stage consists in resection of the styloid processes and muscles followed by anterior displacement of the mandibular condyle. This exposes the vertical segment of the petrous ICA. The petrous stage consists in partial petrectomy exposing the jugular bulb and the third segment of the facial nerve. Using this route, the vertical intrapetrous segment of the ICA can be drilled away without damaging the middle ear. In our series, no vascular complications occurred. Damage involving the facial glossopharyngeal and vagal nerves is discussed. This approach appears to be a suitable alternative to the conventional infratemporal approach which sacrifices the middle ear.
PMID: 7726478