{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T14:46:45Z","timestamp":1794062805034,"version":"4.8.0"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The petrosal process of the sphenoid bone (PPsb) is a relevant skull base osseous prominence present bilaterally that can be used as a key surgical landmark, especially for identifying the abducens nerve. The authors investigated the surgical anatomy of the PPsb, its relationship with adjacent neurovascular structures, and its practical application in endoscopic endonasal surgery.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Twenty-one dried skulls were used to analyze the osseous anatomy of the PPsb. A total of 16 fixed silicone-injected postmortem heads were used to expose the PPsb through both endonasal and transcranial approaches. Dimensions and distances of the PPsb from the foramen lacerum (inferiorly) and top of the posterior clinoid process (PCP; superiorly) were measured. Moreover, anatomical variations and the relationship of the PPsb with the surrounding crucial structures were recorded. Three representative cases were selected to illustrate the clinical applications of the findings.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The PPsb presented as a triangular bony prominence, with its base medially adjacent to the dorsum sellae and its apex pointing posterolaterally toward the petrous apex. The mean width of the PPsb was 3.5 \u00b1 1 mm, and the mean distances from the PPsb to the foramen lacerum and the PCP were 5 \u00b1 1 and 11 \u00b1 2.5 mm, respectively. The PPsb is anterior to the petroclival venous confluence, superomedial to the inferior petrosal sinus, and inferomedial to the superior petrosal sinus; constitutes the inferomedial limit of the cavernous sinus; and delimits the upper limit of the paraclival internal carotid artery (ICA) before the artery enters the cavernous sinus. The PPsb is anterior and medial to and below the sixth cranial nerve, forming the floor of Dorello\u2019s canal. During surgery, gentle mobilization of the paraclival ICA reveals the petrosal process, serving as an accurate landmark for the location of the abducens nerve.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>This investigation revealed details of the microsurgical anatomy of the PPsb, its anatomical relationships, and its application as a surgical landmark for identifying the abducens nerve. This novel landmark may help in minimizing the risk of abducens nerve injury during transclival approaches, which extend laterally toward the petrous apex and cavernous sinus region.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2021.12.jns212024","type":"journal-article","created":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T18:22:41Z","timestamp":1647368561000},"page":"1431-1442","source":"Crossref","is-referenced-by-count":7,"title":["Microsurgical anatomy and the importance of the petrosal process of the sphenoid bone in endonasal surgery"],"prefix":"10.3171","volume":"137","author":[{"given":"Ayoze","family":"Doniz-Gonzalez","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Stanford Hospital, Stanford, California;"},{"name":"Department of Neurosurgery, Hospital Universitario de Canarias, La Laguna, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Vigo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford Hospital, Stanford, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximiliano Alberto","family":"Nunez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford Hospital, Stanford, California;"},{"name":"Department of Neurosurgery, Hospital El Cruce, Buenos Aires, Argentina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanzhi","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford Hospital, Stanford, California;"},{"name":"Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Mohyeldin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford Hospital, Stanford, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron A.","family":"Cohen-Gadol","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Indiana University, Indianapolis; and"},{"name":"The Neurosurgical Atlas, Carmel, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan C.","family":"Fernandez-Miranda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford Hospital, Stanford, California;"},{"name":"The Neurosurgical Atlas, Carmel, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E6","DOI":"10.3171\/foc.2005.19.1.7","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 AB","year":"2005","unstructured":"Kassam AB, Gardner P, Snyderman C, Mintz A, Carrau R. 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