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Craniovertebral Junction Transanasal and Transoral Approaches: Reconstruct the Surgical Pathways with Soft or Hard Tissue Endocopic Lines? This Is the Question

  • Conference paper
Trends in Reconstructive Neurosurgery

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 124))

Abstract

A variety of pathological conditions may affect the clivus and the craniovertebral junction (CVJ). These include congenital disorders, chronic inflammation, neoplasms, infections, and posttraumatic conditions that could all result in CVJ compression and myelopathy Endoscopic-assisted procedures have been further developed for CVJ decompression and they have now become conventional approaches. The aims of the present study were:

(1) to compare “radiological” and “surgical” nasoaxial lines (NAxLs); (2) to introduce an analogous radiological line as a predictor of the superior extension of the transoral approach (palatine inferior dental arch line (PIA); (3) to compare the “radiological” nasopalatine line (NPL) with the “surgical” NPL (SNPL) and surgical PIA (SPIA); (4) to compare “our” SNPL with the NAxL; and (5) to find possible radiological reference points to predict, preoperatively, the maximal extent of superior dissection for the transoral approach (SPIA).

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References

  1. Fang HSY, Ong GB (1962) Direct anterior approach to the upper cervical spine. J Bone Joint Surg Am 44A:1588–1604

    Article  Google Scholar 

  2. Crockard HA (1991) Ventral approaches to the upper cervical spine. Orthopade 20:140–146

    CAS  PubMed  Google Scholar 

  3. Symonds CPMS (1937) Compression of the spinal cord in the neighborhood of the foramen magnum with a note on the surgical approach by Julian Taylor. Brain 60:52–84

    Article  Google Scholar 

  4. Visocchi M, Della Pepa GM, Doglietto F, Esposito G, La Rocca G, Massimi L (2011) Video-assisted microsurgical transoral approach to the craniovertebral junction: personal experience in childhood. Childs Nerv Syst 27:825–831

    Article  PubMed  Google Scholar 

  5. Visocchi M, Pietrini D, Tufo T, Fernandez E, Di Rocco C (2009) Preoperative irreducible C1-C2 dislocations: intra-operative reduction and posterior fixation. The “always posterior strategy”. Acta Neurochir (Wien) 151:551–559

    Article  Google Scholar 

  6. Frempong-Boadu AK, Faunce WA, Fessler RG (2002) Endoscopically assisted transoral-transpharyngeal approach to the craniovertebral junction. Neurosurgery 51:S60–S66

    Article  PubMed  Google Scholar 

  7. Visocchi M, Doglietto F, Della Pepa GM et al (2011) Endoscope-assisted microsurgical transoral approach to the anterior craniovertebral junction compressive pathologies. Eur Spine J 20:1518–1525

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kassam AB, Snyderman C, Gardner P, Carrau R, Spiro R (2005) The expanded endonasal approach: a fully endoscopic transnasal approach and resection of the odontoid process: technical case report. Neurosurgery 57:E213; discussion E213

    PubMed  Google Scholar 

  9. Seker A, Inoue K, Osawa S, Akakin A, Kilic T, Rhoton AL Jr (2010) Comparison of endoscopic transnasal and transoral approaches to the craniovertebral junction. World Neurosurg 74(583):602

    Google Scholar 

  10. Visocchi M, La Rocca G, Della Pepa G et al (2004) Anterior videoassisted apporach to the craniovertebral junction: tansnasal or transoral? Acadaveric study. Acta Neurochir (Wien) 156(2):285–292

    Article  Google Scholar 

  11. Visocchi M, Pappalardo G, Pileggi M, Signorelli F, Paludetti G, La Rocca G (2015) Experimental endoscopic angular domains of transnasal and transoral routes to the craniovertebral junction: light and shade. Spine 41(3)

    Google Scholar 

  12. De Almeida JR, Zanation AM, Snyderman CH et al (2009) Defining the nasopalatine line: the limit for endonasal surgery of the spine. Laryngoscope 119:239–244

    Article  PubMed  Google Scholar 

  13. Aldana PR, Naseri I, La Corte E (2012) The naso-axial line: a new method of accurately predicting the inferior limit of the endoscopic endonasal approach to the craniocervical junction. Neurosurgery 71(2 Suppl Operative):308–314

    Google Scholar 

  14. Messina A, Bruno MC, Decq P et al (2007) Pure endoscopic endonasal odontoidectomy: anatomical study. Neurosurg Rev 30:189–194

    Article  PubMed  PubMed Central  Google Scholar 

  15. Shapiro S, WilkMB CHJA (1968) Comparative study of various tests for normality. J Am Stat Assoc 63:1343–1372

    Article  Google Scholar 

  16. Pillai P, BaigMN KCS, Ammirati M (2009) Endoscopic imageguided transoral approach to the craniovertebral junction: an anatomic study comparing surgical exposure and surgical freedom obtained with the endoscope and the operating microscope. Neurosurgery 64:437–442

    PubMed  Google Scholar 

  17. Visocchi M (2011) Advances in videoassisted anterior surgical approach to the craniovertebral junction. Adv Tech Stand Neurosurg 37:97–110

    Article  Google Scholar 

  18. Visocchi M, Doglietto F, Della Pepa GM et al (2011) Endoscope-assisted microsurgical transoral approach to the anterior craniovertebral junction compressive pathologies. Eur Spine J 20:1518–1525

    Article  PubMed  PubMed Central  Google Scholar 

  19. Vougioukas VI, Hubbe U, Schipper J, Spetzger U (2003) Navigated transoral approach to the cranial base and the craniocervical junction: technical note. Neurosurgery 52:247–250

    PubMed  Google Scholar 

  20. Jho HD, Ha HG (2004) Endoscopic endonasal skull base surgery: part 3-The clivus and posterior fossa. Minim Invasive Neurosurg 47:16–23

    Article  PubMed  Google Scholar 

  21. Messina A, Bruno MC, Decq P et al (2007) Pure endoscopic endonasal odontoidectomy: anatomical study. Neurosurg Rev 30:189–194

    Article  PubMed  PubMed Central  Google Scholar 

  22. Alfieri A, Jho HD, Tschabitscher M (2002) Endoscopic endonasal approach to the ventral cranio-cervical junction: anatomical study. Acta Neurochir (Wien) 144:219–225

    Article  CAS  Google Scholar 

  23. Cavallo LM, Messina A, Cappabianca P et al (2005) Endoscopic endonasal surgery of the midline skull base: anatomical study and clinical considerations. Neurosurg Focus 19(1):E2

    PubMed  Google Scholar 

  24. Visocchi M, Trevisi G, Iacopino DG, Tamburrini G, Caldarelli M, Barbagallo GM (2014) Odontoid process and clival regeneration with Chiari malformation worsening after transoral decompression: an unexpected and previously unreported cause of “accordion phenomenon”. Eur Spine J 24(Suppl 4):S564–S568

    PubMed  Google Scholar 

  25. Visocchi M, Di Martino A, Maugeri R, González Valcárcel I, Grasso V, Paludetti G (2015) Videoassisted anterior surgical approaches to the craniocervical junction: rationale and clinical results. Eur Spine J 24(12):2713–2723

    Article  PubMed  Google Scholar 

  26. Visocchi M (2015) Transnasal and transoral approach to the clivus and the craniovertebral junction. J Neurosurg Sci

    Google Scholar 

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Conflict of Interest Statement

The authors declare that they have not received any funds for this work from any of the following organizations: National Institutes of Health (NIH); Wellcome Trust; Howard Hughes Medical Institute (HHMI); and other foundation(s) requiring open access. Moreover, the authors declare that they have no personal or institutional financial interest in the drugs, materials, or devices described in their submissions.

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Authors and Affiliations

  1. Insitute of Neurosurgery, Medical School, Catholic University of Rome, Rome, Italy

    Massimiliano Visocchi MD, Pierpaolo Mattogno MD, Francesco Signorelli MD & Giuseppe La Rocca MD

  2. Division of Neurosurgery, Department of Neurosciences, Policlinico “G. Rodolico” University Hospital, Catania, Italy

    Giuseppe Barbagallo

  3. Department of Public Health, Institute of Legal Medicine, Catholic University of Rome, Rome, Italy

    Vincenzo Lorenzo Pascali

  4. Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Neurosurgical Clinic, University of Palermo, Palermo, Italy

    Gerardo Iacopino MD

  5. Department of Biomedical Sciences, Neurosurgery, University of Messina, Messina, Italy

    Antonino Germano’ MD

Authors
  1. Massimiliano Visocchi MD
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  2. Giuseppe Barbagallo
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  3. Vincenzo Lorenzo Pascali
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  4. Pierpaolo Mattogno MD
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  5. Francesco Signorelli MD
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  6. Gerardo Iacopino MD
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  7. Antonino Germano’ MD
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  8. Giuseppe La Rocca MD
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Corresponding author

Correspondence to Giuseppe La Rocca MD .

Editor information

Editors and Affiliations

  1. Institute of Neurosurgery Medical School, Catholic University of Rome, Rome, Italy

    Massimiliano Visocchi

  2. Dept. of Neurosurgery, Christian-Albrechts-University of Kiel, Kiel, Germany

    H. Maximilian Mehdorn

  3. Department of Neurological Surgery, Nihon University, Tokyo, Japan

    Yoichi Katayama

  4. Medical Faculty University of Münster, Münster, Germany

    Klaus R. H. von Wild

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Visocchi, M. et al. (2017). Craniovertebral Junction Transanasal and Transoral Approaches: Reconstruct the Surgical Pathways with Soft or Hard Tissue Endocopic Lines? This Is the Question. In: Visocchi, M., Mehdorn, H.M., Katayama, Y., von Wild, K.R.H. (eds) Trends in Reconstructive Neurosurgery. Acta Neurochirurgica Supplement, vol 124. Springer, Cham. https://doi.org/10.1007/978-3-319-39546-3_18

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  • DOI: https://doi.org/10.1007/978-3-319-39546-3_18

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-39545-6

  • Online ISBN: 978-3-319-39546-3

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