Anatomical Triangles for Use in Skull Base Surgery: A Comprehensive Review

Abstract

Procedures performed along the skull base require technical prowess and a thorough knowledge of cranial anatomy to navigate the operative field. Anatomical triangles created by unique anatomical structures serve as landmarks to guide the surgeon during meticulous skull base procedures. The corridors rapidly orient the surgeon to the operative field and permit greater confidence regarding skull base position during dissection. A literature review was performed with use of the PubMed database and reference list searches from full-text reviewed articles, which resulted in the identification of 31 distinct anatomical triangles of the skull base. The 31 anatomical triangles are categorized into a corresponding cranial fossa or the extracranial subsection. The triangles described in the manuscript include junctional, interoptic, precommunicating, opticocarotid, supracarotid, parasellar, clinoidal, oculomotor, carotid-oculomotor, supratrochlear, infratrochlear, anteromedial, quadrangular, anterolateral, posteromedial, posterolateral, lateral, superior petrosal, oculomotor-tentorial, inferomedial, inferolateral, glossopharyngo-cochlear, vagoaccessory, suprahypoglossal, hypoglossal-hypoglossal, infrahypoglossal, parapetrosal, suprameatal, retromeatal, suboccipital, and the inferior suboccipital. The goal of this review is to create a comprehensive resource for existing skull base triangles that includes borders, contents, surgical applications, and illustrations to enhance awareness and inform microsurgical dissection.

Keywords: Anatomy; Cerebrovascular; Cranial nerves; Skull base; Triangles; Windows.