Experimental Endoscopic Angular Domains of Transnasal and Transoral Routes to the Craniovertebral Junction

Abstract

3.

Considerazioni su “Approccio endoscopico endonasale alla cerniera craniocervicale: il ruolo della preservazione dell’arco anteriore di c1 o della sua ricostruzione”

“…More surprisingly, in our experience a complete regeneration of the clivus and odontoid after transoral decompression is possible; in fact, besides the need for accurate complete resection of the periosteum, which apparently was incompletely performed in our case, our experience suggests the need for resection of the odontoid down to the dentocentral synchondrosis, and accurate lateral removal of the bone surrounding the anterior tubercle of the clivus is advised when an anterior CVJ decompression is required in children presenting with evident synchondrosis at neuroradiological investigation 8 . Thus, in conclusion I do not recommend to popularise the non-use of instrumentation systems in such a surgery except in selected cases of spontaneous restorative processes (inflammatory or degenerative) which provide secondary bone fusion 9 - 11 .…”

Nuances of Microsurgical and Endoscope Assisted Surgical Techniques to the Cranio-Vertebral Junction: Review of the Literature

“…The he most commonly used endoscopically assisted approaches to the craniocervical junction include transnasal, transoral and transcervical routes so far (Table 1) [2,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Endoscopic transoral approach: In 2004, de Divitiis et al, studied an endoscopic transoral-transclival intradural approach on 15 cadavers, without maxillotomy or mandibulotomy, and estimated a safe entry zone through the clivus endoscopically [7].…”

“…Visocchi et al [22] SPIA (Surgical Palate Inferior Arcade) represents the maximal extent of the superior dissection for transoral approach. Interestingly it can be drawn by a simple lateral head X conclude that endoscope and image guidance allow to approach the ventral CVJ transorally with minimal tissue dissection, no palatal splitting, and no compromise of surgical freedom [10] ( Figure 1).…”

Nuances of Microsurgical and Endoscope Assisted Surgical Techniques to the Cranio-Vertebral Junction: Review of the Literature

“…Visocchi et al [22] 2015 [22] (Figure 3). From the transoral group, 2 patients had postoperative dysphonia, 1 patient presented with dysphagia, and 1 patient had intraoperative CSF leakage.…”

“…The he most commonly used endoscopically assisted approaches to the craniocervical junction include transnasal, transoral and transcervical routes so far (Table 1) [2,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. specimens by a direct transoral approach; endoscope assisted (5 cases) or combined endoscopic--microscopic aid, evaluating the surgical working area and the surgical freedom; the authors Table 1: major fi ndings in anatomical studies of endoscopic assisted approaches to the cranio cervical junction.…”