Anatomical Aspects of the Transnasal Endoscopic Access to the Craniovertebral Junction

Shkarubo, A N; Nikolenko, V. N.; Chernov, I V; Andreev, D N; Shkarubo, M A; Chmutin, Kirill G; Sinelnikov, Mikhail Y.

doi:10.1016/j.wneu.2019.09.011

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…On the 43rd day after the intervention, the patient was discharged in a satisfactory condition. При эндоскопическом трансназальном доступе хирургическое поле ограничено носовой и нёбной костью, через которые проводят 2 линии -назопалатинную, предложенную А. Кассамом (линия, соединяющая ринион с задним краем твердого нёба), и назокливальную, предложенную А. Шкарубо (линия, соединяющая ринион и нижний отдел ската) -в результате чего образуется треугольная форма хирургического коридора [74,88]. Этот коридор обеспечивает доступ ко всему вентральному отделу КВП в срединной плоскости [10,83].…”

Section: обсуждение основного результата исследованияunclassified

Comparative analysis of endoscopic transnasal and microsurgical transoral odontoidectomy: Literature review and own experience

Shkarubo

Nazarenko

Chernov

et al. 2023

N.N. Priorov Journal of Traumatology and Orthopedics

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BACKGROUND: Odontoidectomy is indicated in the case of anterior compression of brainstem structures by an invaginated dentoid process, and it is currently possible to perform both transoral microsurgical and transnasal endoscopic access. OBJECTIVE: To conduct a comparative analysis of endoscopic transnasal and microsurgical transoral odontoidectomy performed by the first author. MATERIALS AND METHODS: The treatment results of 29 patients with pathological conditions, including anterior compression of stem structures with an invaginated dentoid process, were analyzed. Of 29 patients, 5 (17%) underwent surgery transnasally endoscopically, and 24 (83%) underwent surgery transorally microsurgically. RESULTS: Decompression of brainstem structures was achieved in all cases. The absence of the need to install a tracheostomy before surgery and the smaller volume of oropharyngeal trauma allow patients to undergo transnasal removal of the dentoid process and endure the postoperative period easier and faster. CONCLUSION: Currently, endoscopic transnasal access is gradually replacing transoral access in certain patients who are indicated for anterior odontoidectomy. Moreover, the literature analysis shows an ever deeper development of this technique; however, unambiguous indications of the use of transoral or transnasal access have not been formed at present.

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Section: обсуждение основного результата исследованияunclassified

Comparative analysis of endoscopic transnasal and microsurgical transoral odontoidectomy: Literature review and own experience

Shkarubo

Nazarenko

Chernov

et al. 2023

N.N. Priorov Journal of Traumatology and Orthopedics

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“…1 Tradition-ally, endoscopic odontoidectomies were performed via transoral or transcervical corridors. 2,3 The main disadvantage of endoscopic image-guided transcervical odontoidectomy is an extraordinarily long distance from the odontoid process, especially in high-lying lesions, obese patients, or those with barrel chest or kyphotic cervical spine. 4 In recent years, there has been an increasing interest in new endoscopic corridors to the upper cervical and CVJ.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Endonasal Approach to the Craniovertebral Junction Lesions: A Case Series of 18 Patients

Alijani

Namin

Emamhadi

et al. 2022

J Neurol Surg B Skull Base

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Introduction: Odontoid pathologies constitute a special category because they may lead to instability. Instability is defined by abnormal spinal alignment under physiologic conditions (loads) such as standing, walking, bending, or lifting. Since instability poses a risk of cord damage, surgical interventions may be required for durable long-term stabilization. This study demonstrates operative technique and results of endoscopic endonasal approach to the odontoid. Methods: We conducted a retrospective study involving 18 patients who underwent endoscopic endonasal odontoidectomy (EEO) due to Craniovertebral pathologies. Demographic data, clinical features of the patients, risk factors, intraoperative and postoperative complications were reported in this series. Results: Satisfactory outcomes achieved in 16 patients based on comparing modified Rankin scale before and after the surgery (P value= 0.0001). The mean duration for EEO was 232.6 ± 18.8 minutes. The mean blood loss during surgery was 386.67 ± 153.04 ml. The mean duration of hospital stay was seven days. All patients were extubated within a few hours after surgery. Against the backdrop of a successful anterior decompression in the aforementioned cases, intraoperative cerebrospinal fluid (CSF) leakage, postoperative meningitis, and pulmonary thromboembolism have emerged as devastating complications. However, two intraoperative CSF leakages were managed by direct dural repair and fat graft; two patients died due to postoperative meningitis and pulmonary thromboembolism 7 and 4 days after the second surgery. Conclusion: In conclusion, EEO can be effectively used for anterior decompression of the odontoid pathologies, despite the risk of complications.

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Minimally invasive surgery for invaginated CII odontoid process

Shkarubo¹,

Chernov²,

Andreev³

et al. 2023

Vopr. neirokhir.

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Anatomical Aspects of the Transnasal Endoscopic Access to the Craniovertebral Junction

Cited by 4 publications

References 31 publications

Comparative analysis of endoscopic transnasal and microsurgical transoral odontoidectomy: Literature review and own experience

Comparative analysis of endoscopic transnasal and microsurgical transoral odontoidectomy: Literature review and own experience

Endoscopic Endonasal Approach to the Craniovertebral Junction Lesions: A Case Series of 18 Patients

Minimally invasive surgery for invaginated CII odontoid process

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