Vidian Canal: Analysis and Relationship to the Internal Carotid Artery

Authors

  • Allan D. Vescan MD,

    1. Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
    2. Minimally Invasive endo Neurosurgery Center, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
    Search for more papers by this author
  • Carl H. Snyderman MD,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
    2. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
    3. Minimally Invasive endo Neurosurgery Center, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
    • Carl H. Snyderman, Professor, Department of Otolaryngology and Head & Neck Surgery, Department of Neurological Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street, EEI Suite 500, Pittsburgh, PA 15213 U.S.A
    Search for more papers by this author
  • Ricardo L. Carrau MD,

    1. Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
    2. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
    3. Minimally Invasive endo Neurosurgery Center, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
    Search for more papers by this author
  • Arlan Mintz MD,

    1. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
    2. Minimally Invasive endo Neurosurgery Center, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
    Search for more papers by this author
  • Paul Gardner MD,

    1. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
    2. Minimally Invasive endo Neurosurgery Center, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
    Search for more papers by this author
  • Barton Branstetter IV MD,

    1. Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
    Search for more papers by this author
  • Amin B. Kassam MD

    1. Department of Otolaryngology–Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
    2. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
    3. Minimally Invasive endo Neurosurgery Center, University of Pittsburgh Medical Center, Pittsburgh, PA, U.S.A.
    Search for more papers by this author

  • Presented at the Triological Society Combined Sections Meeting, Marco Island, Florida, U.S.A., February 18, 2007.

Abstract

Objectives: The purpose of this study is to describe the anatomy and relationships of the vidian canal to known endonasal and skull base landmarks. This will allow the endoscopic skull base surgeon to safely approach the anterior genu of the petrous carotid artery during expanded endonasal approaches to the skull base.

Study Design: The study is a prospective cohort study.

Methods: Axial, coronal, and sagittal computed tomography scans of the paranasal sinuses and skull base of 44 patients were examined. Individuals with known skull base pathology were excluded. Measurements included the length of the vidian canal, the relationship of the vidian canal to the anterior genu of the petrous carotid artery, and the type of pneumatization of the sphenoid sinus as it pertains to foramen rotundum and the vidian canal. In addition, we will focus on the relationship of the vidian canal to the sphenopalatine foramen and base of the medial pterygoid plate.

Results: The degree of pneumatization of the sphenoid sinus is highly variable. The mean length of the vidian canal is 18 mm (10–23 mm). The vidian canal is found entirely within bone in 27% to 30% of scans reviewed. The anterior genu of the petrous internal carotid artery is found superior-medial to the vidian canal in 44 of 44 of the CT scans reviewed. The vidian canal runs medial to lateral in 93% to 98% of patients studied.

Conclusions: As a result of this study the endoscopic skull base surgeon has a number of anatomical landmarks and measurements that may be helpful insafely localizing the anterior genu of the petrous internal carotid artery during expanded endonasal approaches to the skull base.

Ancillary