Endoscopic surgical anatomy of the auditory tube, foramen lacerum, and the surrounding structures

Abstract

Observation of the skull base bones and cadaver dissection by a nasal endoscope was performed to visualize the endoscopic anatomy of the auditory tube and the foramen lacerum. The foramen lacerum is an irregular-shaped space formed by the sphenoid, temporal, and occipital bones. After removing the posterior wall of the maxillary sinus, the maxillary artery and its branches were exposed. By removing the periosteum of the anterior wall of the sphenoid bone, the opening of the pterygoid canal was visualized. By drilling the pterygoid process and its medial and lateral plate, the cartilaginous part of the auditory tube was exposed. This cartilage is firmly attached to the groove for this cartilage and the fibrous cartilage of the foramen lacerum. To avoid damaging the internal carotid artery and the cavernous sinus, surgeons should maintain manipulation below the pterygoid canal and foramen lacerum.