{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:22:12Z","timestamp":1790230932158,"version":"4.1.0"},"reference-count":13,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Extended endoscopic transnasal surgeries for skull base lesions have recently been performed. Some expert surgeons have attempted to remove tumors such as chordomas, meningiomas, and pituitary adenomas in the clival region using the transnasal approach and have reported abducens nerve injury as a common complication. There have been many microsurgical anatomical studies of the abducens nerve, but none of these studies has described an anatomical landmark of the abducens nerve in the transnasal approach. In this study the authors used cadaver dissections to describe Gr\u00fcber's ligament as the most reliable landmark of the abducens nerve in the transnasal transclival view.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The petroclival segment of the abducens nerve was dissected in the interdural space\u2014which is also called Dorello's canal, the petroclival venous gulf, or the sphenopetroclival venous confluence\u2014using the transnasal approach in 20 specimens obtained from 10 adult cadaveric heads.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The petroclival segment of the abducens nerve clearly crossed and attached to Gr\u00fcber's ligament in the interdural space, as noted in the transnasal view. The average length of the dural porus to the intersection on the abducens nerve was 5.2 \u00b1 1.0 mm. The length of the posterior clinoid process (PCP) to the intersection on Gr\u00fcber's ligament was 6.4 \u00b1 2.6 mm. The average width of Gr\u00fcber's ligament at the midsection was 1.6 \u00b1 0.5 mm.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Gr\u00fcber's ligament is considered a useful landmark, and it is visible in most adults. Thus, surgeons can find the abducens nerve safely by visualizing inferolaterally along Gr\u00fcber's ligament from the PCP.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.10.jns132437","type":"journal-article","created":{"date-parts":[[2014,11,7]],"date-time":"2014-11-07T15:06:17Z","timestamp":1415372777000},"page":"499-503","source":"Crossref","is-referenced-by-count":19,"title":["Gr\u00fcber's ligament as a useful landmark for the abducens nerve in the transnasal approach"],"prefix":"10.3171","volume":"122","author":[{"given":"Ryosuke","family":"Tomio","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Toda","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agung Budi","family":"Sutiono","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Padjadjaran University Faculty of Medicine, Dr. Hasan Sadikin Hospital, Bandung, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Horiguchi","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadakazu","family":"Aiso","sequence":"additional","affiliation":[{"name":"Anatomy, School of Medicine, Keio University, Tokyo, Japan; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunari","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns132437","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"67","DOI":"10.3171\/jns.1997.87.1.0067","article-title":"A new concept in Dorello's canal microanatomy: the petroclival venous confluence","volume":"87","author":"Destrieux","year":"1997"},{"key":"b2-jns132437","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"366","DOI":"10.3171\/jns.2003.99.2.0366","article-title":"The sphenopetroclival venous gulf: a microanatomical study","volume":"99","author":"Iaconetta","year":"2003"},{"key":"b3-jns132437","series-title":"Turk Neurosurg","first-page":"323","article-title":"Microanatomical characteristics of the petrosphenoidal ligament of Gruber","volume":"20","author":"Icke","year":"2010"},{"issue":"1","key":"b4-jns132437","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Expanded endonasal approach: the rostrocaudal axis. Part II Posterior clinoids to the foramen magnum","volume":"19","author":"Kassam","year":"2005"},{"issue":"1","key":"b5-jns132437","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Expanded endonasal approach: fully endoscopic, completely transnasal approach to the middle third of the clivus, petrous bone, middle cranial fossa, and infratemporal fossa","volume":"19","author":"Kassam","year":"2005"},{"key":"b6-jns132437","series-title":"Neurol Med Chir (Tokyo)","doi-asserted-by":"publisher","first-page":"307","DOI":"10.2176\/nmc.47.307","article-title":"Bilateral traumatic abducens nerve palsy associated with skull base fracture\u2014case report","volume":"47","author":"Katsuno","year":"2007"},{"key":"b7-jns132437","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1227\/NEU.0b013e31825ea3e0","article-title":"Endoscopic endonasal approach for resection of cranial base chordomas: outcomes and learning curve","volume":"71","author":"Koutourousiou","year":"2012"},{"key":"b8-jns132437","series-title":"Skull Base and Related Structures: Atlas of Clinical Anatomy","first-page":"85","author":"Lang","year":"1995"},{"issue":"2 Suppl 1","key":"b9-jns132437","series-title":"Neurosurgery","first-page":"ONS1","article-title":"Microanatomical architecture of Dorello's canal and its clinical implications","volume":"60","author":"Ozveren","year":"2007"},{"key":"b10-jns132437","series-title":"Keio J Med","doi-asserted-by":"publisher","first-page":"152","DOI":"10.2302\/kjm.58.152","article-title":"What are the limits of endoscopic sinus surgery?: the expanded endonasal approach to the skull base","volume":"58","author":"Snyderman","year":"2009"},{"key":"b11-jns132437","series-title":"Surg Radiol Anat","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1007\/s00276-013-1171-8","article-title":"Ossification of the petrosphenoidal ligament: unusual variation with the potential for abducens nerve entrapment in Dorello's canal at the skull base","volume":"36","author":"Tubbs","year":"2014"},{"key":"b12-jns132437","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"294","DOI":"10.3171\/jns.1991.75.2.0294","article-title":"Dorello's canal: a micro-anatomical study","volume":"75","author":"Umansky","year":"1991"},{"key":"b13-jns132437","series-title":"Am J Roentgenol Radium Ther Nucl Med","doi-asserted-by":"publisher","first-page":"177","DOI":"10.2214\/ajr.104.1.177","article-title":"The postnatal development of the sphenoidal sinus and its spread into the dorsum sellae and posterior clinoid processes","volume":"104","author":"Vidi\u0107","year":"1968"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/122\/3\/article-p499.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/122\/3\/article-p499.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/122\/3\/article-p499.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T22:56:21Z","timestamp":1658703381000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/122\/3\/article-p499.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3]]},"references-count":13,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2014.10.jns132437","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,3]]}}}