Endoscopic Submandibular Retropharyngeal Approach to the Craniocervical Junction and Clivus: an Anatomic Study

Salle, Henri; Mendes, George de Albuquerque Cavalcanti; Gantois, Clément; Lerat, J.; Aldahak, Nouman; Caire, François

doi:10.1016/j.wneu.2017.06.162

Cited by 15 publications

(6 citation statements)

References 31 publications

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“…Meanwhile, the CN X was only involved in corridor 2. Careful manipulation should be performed to protect the cranial nerves [ 26 ]. Due to the characteristics of position offset of the BA, only 16 sides of surgical surface involved partial BA of which the volume was slightly more in corridor 2.…”

Section: Discussionmentioning

confidence: 99%

Volumetric comparative analysis of anatomy through far-lateral approach: surgical space and exposed tissues

Tang

Xu²,

XiaodongYuan

et al. 2022

Chin Neurosurg Jl

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Background The three-dimensional (3D) visualization model has ability to quantify the surgical anatomy of far-lateral approach. This study was designed to disclose the relationship between surgical space and exposed tissues in the far-lateral approach by the volumetric analysis of 3D model. Methods The 3D skull base models were constructed using MRI and CT data of 15 patients (30 sides) with trigeminal neuralgia. Surgical corridors of the far-lateral approach were simulated by triangular pyramids to represent two surgical spaces exposing bony and neurovascular tissues. Volumetric comparison of surgical anatomy was performed using pair t test. Results The morphometric results were almost the same in the two surgical spaces except the vagus nerve (CN X) exposed only in one corridor, whereas the volumetric comparison represented the statistical significant differences of surgical space and bony and neurovascular tissues involved in the two corridors (P<0.001). The differences of bony and neurovascular tissues failed to equal the difference of surgical space. Conclusions For far-lateral approach, the increase of exposure for the bony and neurovascular tissues is not necessarily matched with the increase of surgical space. The volumetric comparative analysis is helpful to provide more detailed anatomical information in the surgical design.

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Section: Discussionmentioning

confidence: 99%

Volumetric comparative analysis of anatomy through far-lateral approach: surgical space and exposed tissues

Tang

Xu²,

XiaodongYuan

et al. 2022

Chin Neurosurg Jl

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“… 63 Last, TOA and TNA allow the shortest, widest, and most direct access to the ventral C1 and C2 when compared to the other approaches in the anterior atlantoaxial region. 26 , 64 Cox et al . reported that 43 patients who underwent percutaneous biopsies for cervical spine showed a diagnostic yield of 95%, in which there were five C2 lesions, and Wiesner et al .…”

Section: Discussionmentioning

confidence: 99%

“…Some scholars hold the opinion that the transoral approach affords a reasonably wide runway to C1 and C2, while alternative approaches may be more suitable for lower cervical and upper thoracic vertebrae 63 . Last, TOA and TNA allow the shortest, widest, and most direct access to the ventral C1 and C2 when compared to the other approaches in the anterior atlantoaxial region 26,64 . Cox et al .…”

Section: Discussionmentioning

confidence: 99%

Transnasal Endoscopic and Transoral Approaches in the Biopsies of Ventral Atlas and Axis Vertebrae: A Comprehensive Retrospective Study for Preprocedural Scheme, Biopsy Procedure, Core Technique Analysis, Diagnostic Yield and Clinical Outcome

Shao

et al. 2022

Orthopaedic Surgery

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Objective This study aims to describe and analyze the transoral and transnasal approaches for pathologies of the ventral atlas and axis vertebrae, which are considered technically challenging regions for diagnostic biopsy. Methods A series of transnasal endoscopic approach (TNA) and transoral approach (TOA) biopsies for the pathologies of the first and second cervical vertebrae were conducted and retrospectively analyzed from July 2014 to May 2021. The depth of the biopsy trajectory was measured on computed tomography images for all nine patients (eight males and one female with an average age of 58.11 ± 11.60 years), as were the coronal, sagittal, and vertical biopsy safe ranges. The characteristics of each lesion, including radiographic features, blood supply, and destruction of anterior or posterior vertebral body edges, were evaluated to guide the biopsy. Four biopsy core techniques (BCTs), including “lesion perforating”, “aspiration”, “cutting‐and‐scraping” and “biopsy forceps utilization” were elaborated in this study. The biopsy procedures and periprocedural precautions were demonstrated. Patient demographics, clinical data, lesion characteristics, diagnostic yield, and complications were recorded for each case. Results Eight TOA biopsies for the axis vertebral body and one TNA biopsy for the atlas anterior arch were successfully performed and yielded adequate pathologies. All biopsies were organized based on the preprocedural radiographic measurements, which showed that the average length of biopsy trajectory and coronal, sagittal, and vertical safe biopsy ranges were 85.00 ± 5.88, 20.63 ± 4.75, 16.25 ± 1.49, and 24.63 ± 2.26 mm, respectively, and these corresponding data were 95, 36, 9, and 26 mm in the TNA patient. Six osteolytic lesions (66.7%), one osteoblastic lesion (11.1%), and two mixed lesions (22.2%) were observed, among which seven lesions had a rich blood supply. Biopsy forceps and core needles were utilized to obtain samples in six and three patients, respectively. All the TNA and TOA biopsies were performed with cooperative application of multiple BCTs under compound anatomic and stereotactic navigations. Intraprocedural or postprocedural complications occurred in no patients who underwent the biopsy in the follow‐up period (1–39 months). No significant differences were found between the preprocedural and postprocedural blood indexes and visual analogue scale scores. Conclusion With a sophisticated preprocedural arrangement, cooperative application of BCTs, and careful periprocedural precautions, transnasal endoscopic and transoral biopsies are two feasible, efficient, and well‐tolerated procedures that achieve satisfactory diagnostic yield, complication rate, and clinical outcome.

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“…Transcervical Anterior Approach (TCA) Wolinsky described an endoscopic transcervical approach in order to perform odontoidectomy without traversing the oral cavity 51 . A recent cadaveric study exploited the feasibility of an endoscope-assisted retropharyngeal approach to the CVJ and clivus following submandibular gland resection 52 . The knowledge of the Neurosurgeons of this region gained by cervical spine surgery along with the skill obtained in spine traumatology aimed to screwing the odontoid fractures with biplanar fluoroscopy, make him confident and no surgical alliance seems to be required for this infrequent surgery.…”

Section: Where Alliance Between Neurosurgeons and Otorhinolaringologists Is Unnecessary?mentioning

confidence: 99%

Multidisciplinary approach to the craniovertebral junction. Historical insights, current and future perspectives in the neurosurgical and otorhinolaryngological alliance

Visocchi

Signorelli

Parrilla

et al. 2021

Acta Otorhinolaryngol Ital

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Endoscopic Submandibular Retropharyngeal Approach to the Craniocervical Junction and Clivus: an Anatomic Study

Cited by 15 publications

References 31 publications

Volumetric comparative analysis of anatomy through far-lateral approach: surgical space and exposed tissues

Volumetric comparative analysis of anatomy through far-lateral approach: surgical space and exposed tissues

Transnasal Endoscopic and Transoral Approaches in the Biopsies of Ventral Atlas and Axis Vertebrae: A Comprehensive Retrospective Study for Preprocedural Scheme, Biopsy Procedure, Core Technique Analysis, Diagnostic Yield and Clinical Outcome

Multidisciplinary approach to the craniovertebral junction. Historical insights, current and future perspectives in the neurosurgical and otorhinolaryngological alliance

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