By Vinko V. Dolenc (auth.)
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Additional resources for Microsurgical Anatomy and Surgery of the Central Skull Base
The ICA in the petrous carotid canal has been partially unroofed and lies lateral to the greater petrosal nerve (GPN). The geniculate ganglion (VII) is not covered with bone. The posteromedial triangle lies medial to the GPN, enclosing the apex of the petrous bone (APB). The tensor tympani muscle (TTM) and the lesser petrosal nerve (LPN) are seen postero-Iaterally to the petrous ICA Fig. 29. The left leA in the petrous bone has been unroofed. The greater petrosal nerve (GPN) is adjacent to the lateral surface of the posterior loop (PL), slightly medial to the tensor tympani muscle (TTM) and the eustachian tube.
The interdural venous pool within the lateral wall of the parasellar space (PS) is shown. Note: "Venous blood" is also visible in the paramedial triangle (nerves III and IV) and in the lateral triangle (V2 and V3) Fig. 6~ . "Venous blood" has been removed from the lateral parasellar space (PS) wall in the specimen shown in Figs. 63. "Venous blood" is seen in the paramedial triangle (nerves III and IV), Parkinson's triangle (nerve IV and V1), and over V3. The PS drains lateral and posterior to the Gasserian ganglion (GG) and nerve V, into the superior (SPS) and inferior (IPS) petrosal sinuses Fig.
7c). After identifying the cleavage plane between the layers of the lateral wall of the PS, the outer dural layer is separated from the inner layer, which is left intact over nerves III, IV, Vl and V2 (Fig. 7d). Great care must be taken to avoid injury to these nerves. After dura has been separated from the posterior surface of what SW remains, the bulk of this structure may be removed slowly and carefully with drilling or with a small rongeur, leaving the anterior clinoid process (ACP) intact as the surgeon remains continuously mindful of the ON medially and nerves III, IV, and Vl laterally, still covered by dura.