Trautmann's triangle anatomy with application to posterior transpetrosal and other related skull base procedures

R. Shane Tubbs, Christoph Griessenauer, Marios Loukas, Shaheryar F. Ansari, Michael H. Fritsch, Aaron A. Cohen-Gadol (Lead / Corresponding author)

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Abstract

Trautmann's triangle (TT) faces the cerebellopontine angle and is exposed during posterior transpetrosal approaches. However, reports on the morphometric analysis of this structure are lacking in the literature. The goal was to better understand this important operative corridor. TT was exposed from an external approach (transmastoid) in ten cadavers (20 sides) and from an internal approach on 20 dry adult temporal bones. Measurements included calculation of the area of TT and the distance of the endolymphatic sac from the anterior border of the sigmoid sinus. The area range of TT was 45-210 mm2 (mean 151 mm2 ; SD 37 mm2 ). Three types of triangles were identified based on area. Type I triangles had areas less than 75 mm2 , Type II areas were 75-149 mm2 , and Type III areas were 150 mm2 and greater. These types were observed in 37.5%, 35%, and 27.5% of sides, respectively. The distance from the jugular bulb's anterior border to the posterior border of the posterior semicircular canal ranged from 6 to 11 mm (mean 8.5 mm). The endolymphatic sac was located in the inferior portion of TT and traveled anterior to the sigmoid sinus. The horizontal distance from the anterior edge of the sigmoid sinus to the posterior edge of the endolymphatic sac ranged from 0 to 13.5 mm (mean 9 mm). Additional anatomic knowledge regarding TT may improve neurosurgical procedures in this region by avoiding intrusion into the endolymphatic sac and sigmoid sinus. Clin. Anat., 2014. © 2014 Wiley Periodicals, Inc.

Original languageEnglish
Pages (from-to)994-998
Number of pages5
JournalClinical Anatomy
Volume27
Issue number7
Early online date16 Jan 2014
DOIs
Publication statusPublished - 8 Sep 2014

Keywords

  • skull base
  • Neurosurgery
  • posterior cranial fossa
  • mastoid bone
  • Trautmann's triangle

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    Tubbs, R. S., Griessenauer, C., Loukas, M., Ansari, S. F., Fritsch, M. H., & Cohen-Gadol, A. A. (2014). Trautmann's triangle anatomy with application to posterior transpetrosal and other related skull base procedures. Clinical Anatomy, 27(7), 994-998. https://doi.org/10.1002/ca.22363