Chinese Journal of Clinical Anatomy >
An endoscopic anatomic study of the ventral craniocervical junction with the assistance of neuronavigation
Received date: 2017-08-02
Online published: 2018-03-06
Objective The aim of this study was to evaluate the feasibility of endoscope assisted far-lateral approach with neuronavigational guidance and to observe the anatomic structures of ventral craniocervical junction identified with the endoscope. Methods Six fresh cadaveric specimens were prepared for a far lateral approach to allow for microscopic, 0 degree endoscopic and 30 degrees endoscopic view. By drilling off the jugular tubercle and one-third of the occipital condyle with neuronavigation guidance, the increase in exposure and neurovascular structures visualization with the microscope were then evaluated. The exposure of the petroclivus area provided by the endoscope and by the operating microscope was measured and compared. Results Clear close-up views of the all neurovascular structures in deep ventral craniocervical junction and structures normally obstructed by the jugular tubercle and occipital condyle were obtained using the endoscope through three corridors enclosed with cranial nerves with neuronavigational guidance, as similar with far lateral transcondylar approach. Conclusion With the aid of the endoscope and neuronavigation guidance, the far lateral approach is a feasible procedure that allows the identification of all neurovascular structures in ventral craniocervical junction without drilling the jugular tubercle and occipital condyle and may be used to remove lesions involving in this area.
GUAN Min-wu , YAN Yu-jin , CHEN Ling . An endoscopic anatomic study of the ventral craniocervical junction with the assistance of neuronavigation[J]. Chinese Journal of Clinical Anatomy, 2018 , 36(1) : 1 -4 . DOI: 10.13418/j.issn.1001-165x.2018.01.001
[1] 胡昌辰，吉宏明，张世渊，等. 神经导航辅助内镜下经鼻蝶切除垂体腺瘤139例[J]. 中华医学杂志，2015，95(5)：339-343.
[2] Hermann EJ, Esmaeilzadeh M, Ertl P, et al. Endoscopic intracranial surgery enhanced by electromagnetic-guided neuronavigation in children[J]. Childs Nerv Syst, 2015, 31(8): 1327-33.
[3] Sen C, Shrivastava R, Anwar S, et al. Lateral transcondylar approach for tumors at the anterior aspect of the craniovertebral junction[J]. Neurosurgery, 2010, 66(3): A104-A112.
[4] Hayashi N, Cohen AR. Endoscope-assisted far-lateral transcondylar approach to the skull base[J]. Minim Invas Neurosurg, 2002, 45(3): 132-135.
[5] 彭志强，李少华，田广永，等. 内镜辅助下远外侧髁后锁孔手术入路的解剖学研究[J]. 中国临床解剖学杂志，2008，26（1）：17-20.
[6] 曹杰，缪星宇，师蔚. 神经内镜辅助远外侧锁孔入路显微解剖学研究[J]. 中华神经外科疾病研究杂志，2014，13(3)： 220-223.
[7] Kshettry VR, Benzel EC. Endoscopic-assisted techniques at the craniovertebral junction: understanding indications and limitations[J]. World Neurosurg，2014，82(6):e711-712.
[8] 张恒柱，兰青，贡志刚，等. 神经导航在远外侧锁孔入路解剖学研究中的应用[J]. 中国临床解剖学杂志, 2009, 27(2):119-122.
[9] Rohde V, Behm T, Ludwig H, et al. The role of neuronavigation in intracranial endoscopic procedures[J]. Neurosurg Rev, 2012,35(3): 351-358.
[10]Chotai S, Kshettry VR, Ammirati M. Endoscopic-assisted microsurgical techniques at the craniovertebral junction: 4 illustrative cases and literature review[J]. Clin Neurol Neurosurg, 2014, 121:1-9.
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