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March 13, 2026Operative Neurosurgery

360° to the Petrous Apex: Comprehensive Surgical Anatomy and Limitations of Open and Endoscopic Endonasal Approaches to the Petrous Apex

A. Yohan Alexander Edoardo Agosti Pedro Plou Stephen Graepel Carlos D. Pinheiro-Neto Luciano C. P. C. Leonel Jacob G. Eide Jamie J. Van Gompel Michael J. Link Maria Peris-Celda

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Key Points

This research aims to provide detailed insights into the surgical anatomy of the petrous apex.
Illustrative anatomical dissections
Representative case studies
Overview of surgical anatomy of the petrous apex
Identification of limitations of endoscopic endonasal approaches

Implication

Comprehensive overview illustrates limitations of endoscopic endonasal approaches to the petrous apex.

Abstract

We provide a comprehensive overview of the main approaches to the PA through illustrative anatomic dissections and representative cases.

Discussion

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Cite This Study

Alexander et al. (2026) studied this question.

synapsesocial.com/papers/69b5ff6e83145bc643d1c016 https://doi.org/10.1227/ons.0000000000001976

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Keep reading

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

1Contralateral Nasofrontal Trephination: A Novel Corridor for a “Dual Port” Approach to the Petrous Apex2024 · 6 citations
2Surgical management of petrous apex lesions: a descriptive analysis of outcomes by anatomical location for the Kawase, retrosigmoid, and pterional approachesCohort Study · 2026 · 1 citations
3Purely endoscopic subtemporal keyhole anterior transpetrosal approach to access the petrous apex region: surgical techniques and early results2024 · 9 citations
4Endoscopic transorbital approach to the petrous apex: is orbital rim removal worthwhile for the exposure? An anatomical study with illustrative case2024 · 13 citations
5Anterior and Middle Petrosectomy via an Extended Transorbital Neuroendoscopic Approach: Anatomic Study2024

More related papers

The “Inferior” Petrolingual Ligament for Endoscopic Endonasal “Lateral” Transpetrosal Approach2025
A multidirectional extradural corridor for pretemporal endoscope-assisted orbitozygomatic–anterior petrosectomy2026
Combined Endoscopic Endonasal Transclival and Contralateral Transmaxillary Approach to the Petrous Apex and the Petroclival Synchondrosis: Working “Around the Corner” of the Internal Carotid Artery—Quantitative Anatomical Study and Clinical Applications2024

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