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

Abstract

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.

Surgical management of a foramen magnum tumor via a far-lateral approach using an oblique straight incision: a case series report and technique note

“…A far-lateral approach is a common approach to dealing with lesions on the ventral side of the foramen magnum area and jugular foramen area ( 11 , 12 ). Various surgical incisions using this approach have been reported in the literature, such as the “C”-shaped incision, the reverse “U”-shaped incision, the crutch-shaped incision, and the lateral retrooccipital “S”-shaped incision ( 13 – 17 ).…”

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“…A far-lateral approach is a common approach to dealing with lesions on the ventral side of the foramen magnum area and jugular foramen area (11,12). Various surgical incisions using this approach have been reported in the literature, such as the "C"shaped incision, the reverse "U"-shaped incision, the crutch-shaped incision, and the lateral retrooccipital "S"-shaped incision (13)(14)(15)(16)(17).…”