Comparative Analysis of the Transcranial “Far Lateral” and Endoscopic Endonasal “Far Medial” Approaches: Surgical Anatomy and Clinical Illustration

The Endoscopic Endonasal Approach for Removal of Petroclival Chondrosarcomas

“…The surgical anatomy of the petroclival region and its surroundings, 7-10 as well as of the related endonasal approaches, [11][12][13][14][15][16][17] has been described. The key landmarks and structures from a ventral perspective are illustrated in Fig.…”

Laminoplasty using the posterior midline approach in the treatment of c1-2 spinal tumors

“…The various approaches include posterior, posterolateral, anterior, and anterolateral. When a posterior approach is not possible, a posterolateral approach is used, especially in the treatment of posterior cranial fossa (6). In order to maintain the cervical spine alignment…”

The Endoscopic Endonasal Approach to the Hypoglossal Canal

“…This can be associated with high clinical morbidity and complications such as CNs X and XI palsies. 10,11 Benet et al 12 divided the surfaces of the brainstem into the ventromedial and dorsolateral compartments, which were defined as the spaces anterior and posterior to CNs VII through XII, respectively. Although the lateral, transcranial approaches are the primary accepted surgical options in approaching lesions in the dorsolateral compartment, there is no standard method for approaching lesions of the ventromedial compartment.…”

“…19 Since the supracondylar groove was identified and proposed as a reliable anatomic landmark, this approach to the inferior clival region and hypoglossal canal has been anatomically studied in a comparative analysis of the far-medial EEA and far-lateral transcranial, transcondylar approaches to the inferolateral clival region and craniovertebral junction, which confirmed initial reports that the far-medial endoscopic approach is an ideal operative technique for lesions ventromedial to the brainstem. 12 Additionally, the EEA approach to the inferior clival region has been successfully described in vivo in the management of a chordoma involving the inferior clivus, occipital condyle, and jugular tubercle. 12,20 However, given the nov-elty of this approach, the nuances of the operative corridor and surgical landmarks continue to be refined and characterized.…”

“…12 Additionally, the EEA approach to the inferior clival region has been successfully described in vivo in the management of a chordoma involving the inferior clivus, occipital condyle, and jugular tubercle. 12,20 However, given the nov-elty of this approach, the nuances of the operative corridor and surgical landmarks continue to be refined and characterized.…”