Advertisement

The Endonasal Endoscopic Approach to Pathologies of the Anterior Craniocervical Junction: Analytical Review of Cases Treated at Four European Neurosurgical Centres

  • Salvatore Chibbaro
  • Mario Ganau
  • Helene Cebula
  • Beniamino Nannavecchia
  • Julien Todeschi
  • Antonio Romano
  • Christian Debry
  • Francois Proust
  • Alessandro Olivi
  • Stephane Gaillard
  • Massimiliano Visocchi
Chapter
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 125)

Abstract

Supported by preliminary anatomical and clinical studies exploring the feasibility and usefulness of approaching many ventral pathologies of the craniocervical junction (CCJ) using the endoscopic endonasal approach, four European centres have joined forces to accumulate and share their growing surgical experience of this advanced technique. By describing the steps that led to the development and continuous refinement of this approach to the CCJ, this article delves deeply into an analysis of the cases operated on since 2010 at these four institutions, and discusses in detail the operative nuances that so far have allowed achievement of successful outcomes with excellent perioperative patient comfort and satisfactory long-term quality of life.

Keywords

Endoscopy Endonasal Transoral Odontoidectomy Basilar impression/invagination Odontoid pannus 

Notes

Competing Interests

The authors declare that they have no competing interests.

Compliance with Ethical Standards

No financial support was received for this work.

All procedures performed in the study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Jho HD, Carrau RL, McLaughlin MR, Somaza SC. Endoscopic transsphenoidal resection of a large chordoma in the posterior fossa. Acta Neurochir. 1997;139:343–8.CrossRefGoogle Scholar
  2. 2.
    Jho HD, Ha HG. Endoscopic endonasal skull base surgery: part 3. The clivus and posterior fossa. Minim Invasive Neurosurg. 2004;47:16–23.CrossRefGoogle Scholar
  3. 3.
    Crockard HA, Pozo JL, Ransford AO, Stevens JM, Kendall BE, Essigman WK. Transoral decompression and posterior fusion for rheumatoid atlanto-axial subluxation. J Bone Jt Surg Br. 1986;68:350–6.CrossRefGoogle Scholar
  4. 4.
    Crockard HA, Sen CN. The transoral approach for the management of intradural lesions at the craniovertebral junction: review of 7 cases. Neurosurgery. 1991;28:88–98.CrossRefGoogle Scholar
  5. 5.
    de Almeida JR, Zanation AM, Snyderman CH, Carrau RL, Prevedello DM, Gardner PA, Kassam AB. Defining the nasopalatine line: the limit for endonasal surgery of the spine. Laryngoscope. 2009;119(2):239–44.CrossRefGoogle Scholar
  6. 6.
    Dickman CA, Spetzler RF, Sonntag VK. Surgery of the craniovertebral junction. New York: Thieme; 1998.Google Scholar
  7. 7.
    Di Lorenzo N. Craniocervical junction malformation treated by transoral approach. A survey of 25 cases with emphasis on postoperative instability and outcome. Acta Neurochir. 1992;118:112–6.CrossRefGoogle Scholar
  8. 8.
    Donald PJ. Transoral approach to the clivus and upper cervical spine. In: Donald PJ, editor. Surgery of the skull base. Philadelphia: Lippincott-Raven; 1998. p. 507–32.Google Scholar
  9. 9.
    Hayakawa T, Kamikawa K, Ohnishi T, Yoshimine T. Prevention of postoperative complications after a transoral transclival approach to basilar aneurysms. J Neurosurg. 1981;54:699–703.CrossRefGoogle Scholar
  10. 10.
    Menezes AH, Graf CJ, Hibri N. Abnormalities of the craniovertebral junction with cervico-medullary compression. A rational approach to surgical treatment in children. Childs Brain. 1980;7:15–30.PubMedGoogle Scholar
  11. 11.
    Shaha AR, Johnson R, Miller J, Milhorat T. Transoral–transpharyngeal approach to the upper cervical vertebrae. Am J Surg. 1993;166(4):336–40.CrossRefGoogle Scholar
  12. 12.
    Yang SY, Gao YZ. Clinical results of the transoral operation for lesions of the craniovertebral junction and its abnormalities. Surg Neurol. 1999;51(1):16–20.CrossRefGoogle Scholar
  13. 13.
    Cappabianca P, Alfieri A, de Divitiis E. Endoscopic endonasal transsphenoidal approach to the sella: towards functional endoscopic pituitary surgery (FEPS). Minim Invasive Neurosurg. 1998;41:66–73.CrossRefGoogle Scholar
  14. 14.
    Cappabianca P, Frank G, Pasquini E, de Divitiis O, Calbucci F. Extended endoscopic endonasal transsphenoidal approaches to the suprasellar region, planum sphenoidale and clivus. In: de Divitiis E, Cappabianca P, editors. Endoscopic endonasal transsphenoidal surgery. New York: Springer; 2003. p. 176–87.CrossRefGoogle Scholar
  15. 15.
    Alfieri A, Jho HD, Tschabitscher M. Endoscopic endonasal approach to the ventral cranio-cervical junction: anatomical study. Acta Neurochir (Wien). 2002;144(3):219–25.CrossRefGoogle Scholar
  16. 16.
    Baird CJ, Conway JE, Sciubba DM, Prevedello DM, Quiñones-Hinojosa A, Kassam AB. Radiographic and anatomic basis of endoscopic anterior craniocervical decompression: a comparison of endonasal, transoral, and transcervical approaches. Neurosurgery. 2009;65(6 Suppl):158–64.PubMedGoogle Scholar
  17. 17.
    Cavallo LM, Cappabianca P, Messina A, Esposito F, Stella L, de Divitiis E, Tschabitscher M. The extended endoscopic endonasal approach to the clivus and cranio-vertebral junction: anatomical study. Childs Nerv Syst. 2007;23(6):665–71.CrossRefGoogle Scholar
  18. 18.
    Chibbaro S, Cornelius JF, Froelich S, Tigan L, Kehrli P, Debry C, Romano A, Herman P, George B, Bresson D. Endoscopic endonasal approach in the management of skull base chordomas—clinical experience on a large series, technique, outcome, and pitfalls. Neurosurg Rev. 2013;37(2):217–24.CrossRefGoogle Scholar
  19. 19.
    Choudhri O, Mindea SA, Feroze A, Soudry E, Chang SD, Nayak JV. Experience with intraoperative navigation and imaging during endoscopic transnasal spinal approaches to the foramen magnum and odontoid. Neurosurg Focus. 2014;36(3):E4.CrossRefGoogle Scholar
  20. 20.
    Kassam A, Snyderman CH, Mintz A, Gardner P, Carrau RL. Expanded endonasal approach: the rostrocaudal axis. Part II. Posterior clinoids to the foramen magnum. Neurosurg Focus. 2005;19:E4.PubMedGoogle Scholar
  21. 21.
    Fries G, Perneczky A. Endoscope-assisted brain surgery: part 2—analysis of 380 procedures. Neurosurgery. 1998;42(2):226–32.CrossRefGoogle Scholar
  22. 22.
    Kassam AB, Snyderman C, Gardner P, Carrau R, Spiro R. The expanded endonasal approach: a fully endoscopic transnasal approach and resection of the odontoid process: technical case report. Neurosurgery. 2005;57:E213.PubMedGoogle Scholar
  23. 23.
    La Corte E, Aldana PR, Ferroli P, Greenfield JP, Härtl R, Anand VK, Schwartz TH. The rhinopalatine line as a reliable predictor of the inferior extent of endonasal odontoidectomies. Neurosurg Focus. 2015;38(4):E16.CrossRefGoogle Scholar
  24. 24.
    McGirt MJ, Attenello FJ, Sciubba DM, Gokaslan ZL, Wolinsky JP. Endoscopic transcervical odontoidectomy for pediatric basilar invagination and cranial settling. Report of 4 cases. J Neurosurg Pediatr. 2008;1(4):337–42.CrossRefGoogle Scholar
  25. 25.
    Messina A, Bruno MC, Decq P, Coste A, Cavallo LM, de Divittis E, Cappabianca P, Tschabitscher M. Pure endoscopic endonasal odontoidectomy: anatomical study. Neurosurg Rev. 2007;30(3):189–94.CrossRefGoogle Scholar
  26. 26.
    Visocchi M, Di Martino A, Maugeri R, González Valcárcel I, Grasso V, Paludetti G. Videoassisted anterior surgical approaches to the craniocervical junction: rationale and clinical results. Eur Spine J. 2015;24(12):2713–23.  https://doi.org/10.1007/s00586-015-3873-6.CrossRefPubMedGoogle Scholar
  27. 27.
    Cavallo LM, Messina A, Cappabianca P, Esposito F, de Divitiis E, Gardner P, Tschabitscher M. Endoscopic endonasal surgery of the midline skull base: anatomical study and clinical considerations. Neurosurg Focus. 2005;19:E2.PubMedGoogle Scholar
  28. 28.
    Aldana PR, Naseri I, La Corte E. The naso-axial line: a new method of accurately predicting the inferior limit of the endoscopic endonasal approach to the craniovertebral junction. Neurosurgery. 2012;71(2 Suppl Operative):ONS308–14.PubMedGoogle Scholar
  29. 29.
    Chibbaro S, Gaillard S. Endoscopic endonasal odontoidectomy. In: Cappabianca P, Cavallo LM, de Divitiis O, Esposito F, editors. Midline skull base surgery. New York: Springer; 2016. p. 313–21.CrossRefGoogle Scholar
  30. 30.
    Goldschlager T, Härtl R, Greenfield JP, Anand VK, Schwartz TH. The endoscopic endonasal approach to the odontoid and its impact on early extubation and feeding. J Neurosurg. 2015;122(3):511–8.  https://doi.org/10.3171/2014.9.JNS14733.CrossRefPubMedGoogle Scholar
  31. 31.
    Gardner PA, Tormenti MJ, Pant H, Fernandez-Miranda JC, Snyderman CH, Horowitz MB. Carotid artery injury during endoscopic endonasal skull base surgery: incidence and outcomes. Neurosurgery. 2013;73(2 Suppl Operative):ONS261–70.PubMedGoogle Scholar
  32. 32.
    Nayak JV, Gardner PA, Vescan AD, Carrau RL, Kassam AB, Snyderman CH. Experience with the expanded endonasal approach for resection of the odontoid process in rheumatoid disease. Am J Rhinol. 2007;21(5):601–6.CrossRefGoogle Scholar
  33. 33.
    Frank G, Pasquini E, Mazzatenta D. Extended sphenoidal approach. J Neurosurg. 2001;95:917–8.PubMedGoogle Scholar
  34. 34.
    Iacoangeli M, Gladi M, Alvaro L, Di Rienzo A, Specchia N, Scerrati M. Endoscopic endonasal odontoidectomy with anterior C1 arch preservation in elderly patients affected by rheumatoid arthritis. Spine J. 2013;13(5):542–8.  https://doi.org/10.1016/j.spinee.2013.01.043.CrossRefPubMedGoogle Scholar
  35. 35.
    Laufer I, Greenfield JP, Anand VK, Hartl R, Schwartz TH. Endonasal endoscopic resection of the odontoid process in a non achondroplastic dwarf with juvenile rheumatoid arthritis: feasibility of the approach and utility of the intraoperative Iso-C three-dimensional navigation. Case report. J Neurosurg Spine. 2008;8(4):376–80.CrossRefGoogle Scholar
  36. 36.
    Perez-Orribo L, Little AS, Lefevre RD, Reyes PR, Newcomb AG, Prevedello DM, Roldan H, Nakaji P, Dickman CA, Crawford NR. Biomechanical evaluation of the craniovertebral junction after anterior unilateral condylectomy: implications for endoscopic endonasal approaches to the cranial base. Neurosurgery. 2013;72(6):1021–30.  https://doi.org/10.1227/NEU.0b013e31828d6231.CrossRefPubMedGoogle Scholar
  37. 37.
    Ponce-Gomez JA, Ortega-Porcayo LA, Soriano-Barón HE, Sotomayor-González A, Arriada-Mendicoa N, Gómez-Amador JL, Palma-Díaz M, Barges-Coll J. Evolution from microscopic transoral to endoscopic endonasal odontoidectomy. Neurosurg Focus. 2014;37(4):E15.CrossRefGoogle Scholar
  38. 38.
    Singh H, Grobelny BT, Harrop J, Rosen M, Lober RM, Evans J. Endonasal access to the upper cervical spine, part one: radiographic morphometric analysis. J Neurol Surg B Skull Base. 2013;74(3):176–84.  https://doi.org/10.1055/s-0033-1342923.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Zenga F, Pacca P, Tardivo V, Pennacchietti V, Garbossa D, Pecorari G, Ducati A. Endoscopic endonasal approach to the odontoid pathologies. World Neurosurg. 2016;89:394–403.  https://doi.org/10.1016/j.wneu.2016.02.011.CrossRefPubMedGoogle Scholar
  40. 40.
    Zenga F, Marengo N, Pacca P, Pecorari G, Ducati A. C1 anterior arch preservation in transnasal odontoidectomy using three-dimensional endoscope: a case report. Surg Neurol Int. 2015;6:192.  https://doi.org/10.4103/2152-7806.172696.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Salvatore Chibbaro
    • 1
  • Mario Ganau
    • 1
  • Helene Cebula
    • 1
  • Beniamino Nannavecchia
    • 1
  • Julien Todeschi
    • 1
  • Antonio Romano
    • 2
  • Christian Debry
    • 3
  • Francois Proust
    • 1
  • Alessandro Olivi
    • 4
  • Stephane Gaillard
    • 5
  • Massimiliano Visocchi
    • 4
  1. 1.Department of NeurosurgeryStrasbourg University HospitalStrasbourgFrance
  2. 2.Department of NeurosurgeryParma University HospitalParmaItaly
  3. 3.ENTStrasbourg University HospitalStrasbourgFrance
  4. 4.Institute of NeurosurgeryCatholic University of RomeRomeItaly
  5. 5.Department of NeurosurgeryFoch HospitalParisFrance

Personalised recommendations