Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_4368_Библиотеки_им_академика_М_И_Перельмана
.pdf
Far Lateral-Craniovertebral Approach
https://t.me/med1917
artery (Fig. 29.2a). It is important to maintain midline
orientation by palpating the spinous processes of the
upper cervical vertebrae. Preservation of a muscle “cuff”
at the level of the superior nuchal line is helpful to correct
approximation of the musculature at the end of the
procedure and in prevention of a cerebrospinal fluid (CSF)
leak (Fig. 29.2b).
Muscle Dissection
From an anatomic point of view, three layers of muscles
are identified during the dissection: the superficial layer,
which includes the trapezius and sternocleidomastoid
Fig. 29.1 Anatomic picture showing the head position and
the diff erent skin incisions that can be performed for the
far lateral approach. Red points represent the main external
anatomic landmarks: the inion, the transverse process of the
atlas, and the mandibular angle.
muscles; the middle layer, which consists of the splenius
capitis, longissimus capitis, and semispinalis capitis
(Fig. 29.2a, b) muscles; and the deep layer of muscles
composed of the rectus capitis posterior major medially,
the inferior oblique inferiorly, and the superior oblique
muscle superolaterally. These three muscles represent the
suboccipital triangle (Fig. 29.3a). The muscular stage can
be divided into two steps. First, the sternocleidomastoid
muscle is detached laterally. Then, all other occipital–
cervical muscles are detached medially and inferiorly,
until the suboccipital triangle and the vertebral artery
inside are identified (Fig. 29.3b).
In taking down the muscle and skin flap, several
landmarks are identified and followed. The transverse
process of C1 is a valid landmark for lateral exposure.
After the spinous processes of C1 and C2 are identified,
the lamina of C2 is exposed, as is the ipsilateral portion
of the posterior arch of C1 (Fig. 29.4a). The posterior arch
of C1 is followed laterally to the sulcus arteriosus, which
marks the medial limit of the vertebral artery (Fig. 29.4b).
It is important to localize and identify the vertebral artery
itself along with its surrounding venous plexus to better
protect the artery during drilling of the posterior portion
of the occipital condyle.
Vertebral Artery Exposition
The suboccipital triangle is composed of the rectus
capitis posterior major muscle above and medially, the
superior oblique muscle above and laterally, and the
inferior oblique muscle below and laterally. It is covered
by the semispinalis capitis muscle medially and the
splenius capitis muscle laterally. Its floor is formed by the
posterior atlantooccipital membrane. The suboccipital
triangle involves the dorsal ramus of the Cl nerve root
and the V3 horizontal segment of the vertebral artery.
After identifying the suboccipital triangle under the
semispinalis muscle, the surgical strategy is to perform
a thorough dissection of vertebral artery (Fig. 29.4). This
triangle can be opened by detaching the insertions of the
a
Fig. 29.2 Anatomic pictures showing the dissection of the soft tissue, the galea (a) and superfi cial layer of the muscles (a, b).
A(small), asterion; EOP, external occipital protuberance; OA, occipital artery; SCM, sternocleidomastoid; SNL, superior nuchal line;
SpC, splenius capitis; SsC, semispinalis capitis; T, trapezius.
SsC
T
SpC
OA
SCM
EOP
SNL
SsC
T
b
A
SpC
305
Far Lateral-Craniovertebral Approach
https://t.me/med1917
ST
IOM
SOM
VA
C1
A
TP
IOM
RCPm
RCPM
a
Fig. 29.3 Anatomic pictures showing the dissection of the suboccipital triangle (purple). C1, atlas; IOM, inferior oblique muscle;
RCPm, rectus capitis posterior minor; RCPM, rectus capitis posterior major; SOM, superior oblique muscle; ST, suboccipital triangle.
RCPM
VA
ST
IOM
IOM
SOM
C1
b
SOM
RCPM
fm
dm
C1
a
Fig. 29.4 Anatomic pictures showing the dissection of the suboccipital triangle and the vertebral artery. A, asterion; C1, atlas; dm,
dura mater; fm, foramen magnum; IOM, inferior oblique muscle; RCPM, rectus capitis posterior major; SOM, superior oblique muscle;
TP, transverse process; VA, vertebral artery.
superior and inferior oblique muscles from the transverse
process of C1 and reflecting them posteriorly. Exposure
and control of the extradural vertebral artery can
be achieved by identifying its extradural course from the
foramen transversarium of C2 to the foramen magnum
(Fig. 29.5). Several small muscular branches and the
posterior meningeal artery arise from the horizontal
b
craniotomy should be extended until the edges
of foramen magnum, and the posterior arch of C1
should be resected (Figs. 29.6, 29.7). At this point, the
posterior portion of the occipital condyle can drilled
out to expose the hypoglossal canal. Once the drilling
has been performed, the hypoglossal nerve comes into
view (Fig. 29.8a, b, Fig. 29.9).
segment of the vertebral artery, which can be safely
coagulated during surgery. In some cases, the posterior
spinal artery and the posterior inferior cerebellar artery
(PICA) arise extradurally and they can be injured.
Subperiosteal dissection of the vertebral artery from
the vertebral groove reduces bleeding from the venous
plexus by leaving the periosteal sheath around the artery
intact. The atlantooccipital membrane is sharply divided
to expose the underlying dura (Fig. 29.5).
Dural Opening
The dura is incised in a curvilinear fashion. The exposure
obtained encompasses the lower cranial nerves to C2
(Fig. 29.10). Superior extension of this basic approach
allows the surgeon to follow lesions up to the internal
auditory meatus. The main intradural anatomic
structures that can be exposed are the following: the
Craniotomy
A retromastoid craniotomy is performed with
complete exposure of transverse and sigmoid sinus
as the superior and lateral limits. Inferiorly, the
acoustic–facial bundle, the lower cranial nerves entering
the jugular foramen, the dorsal cervical roots until C2,
the PICA and its branches, the posterior meningeal
artery and the intra-extradural course of the vertebral
artery (Fig. 29.10).
306
fm
https://t.me/med1917
dm
LM
VA
Far Lateral-Craniovertebral Approach
Fig. 29.5 Anatomic picture
showing complete dissection of the
craniovertebral junction. C1, atlas;
C2, second cervical vertebra; C2 g,
second cervical root ganglion; dm,
dura mater; fm, foramen magnum;
LM, lateral mass; mb, muscle branch
of the vertebral artery; TP, transverse
process; VA, vertebral artery.
C2
C1
C2g
TP
mb
VA
A
dm
Fig. 29.6 Three-dimensional computed tomography–based
reconstruction model showing the size and the features of the
far lateral approach.
29.2 Extended Endoscopic
Endonasal Transclival Approach
to the Ventrolateral Brain Stem
29.2.1 Introduction
The endoscopic endonasal approach to the clivus
represents an increasingly important surgical corridor for
skull base surgery. It provides surgical access to the ventral
midline skull base of the middle and posterior cranial fossa.
VA
C1
C2
Fig. 29.7 Anatomic picture showing the suboccipital
craniotomy. A, asterion C1, atlas; C2, second cervical vertebra;
dm, dura mater; VA, vertebral artery.
307
Far Lateral-Craniovertebral Approach
https://t.me/med1917
fm
dm
TP
C1
ab
Fig. 29.8 Anatomic picture showing the drilling of the occipital condyle (a) and the complete exposure of the hypoglossal canal (b).
C1, atlas; dm, dura mater; fm, foramen magnum; Hc, hypoglossal canal; TP, transverse process; VA, vertebral artery.
VA
fm
dm
C1
Hc
TP
VA
were divided into two major steps: first, midline exposure
through an endoscopic inferior transclival approach
and, second, a coronal expansion through ventromedial
condylectomy (unilateral and bilateral).
29.2.2 Surgical Steps
dm
Hc
Patient Positioning
The patient is placed supine with the head fixed in
a three-pin Mayfield holder and elevated 20 to 30
degrees, slightly rotated toward the side of the surgeon
and slightly more flexed than for a common endoscopic
procedure for a sellar lesion, to improve the field of view
toward the clivus.
C1
VA
Fig. 29.9 Anatomic picture showing the suboccipital
craniotomy and the exposure of the hypoglossal canal. C1, atlas;
dm, dura mater; Hc, hypoglossal canal; VA, vertebral artery.
The approach is mostly used for removal of chordomas,
chondrosarcomas, and meningiomas. Cadaveric studies
have documented the extensive exposure through the
endoscopic endonasal transclival approach, and surgical
case descriptions have provided evidence of success in
treating complex skull base pathologies.
1,12,13,21,22,24
The
endoscopic endonasal far medial approach is a coronal
expansion of a conventional extended endoscopic
endonasal approach to the lower third of the clivus.
25–29
From an anatomic perspective, it can be described as
the ventral route to the condylar region and to adjacent
structures such as the jugular foramen (lateral), the
jugular tubercle (cranial), and the craniocervical junction
(caudal). The surgical approach and anatomic dissections
Nasal and Sphenoidal Phases
In contrast to the standard approach to the sellar area, any
extended approach requires a wide and comfortable surgical
corridor, according to the basic principles introduced by
Kassam et al.
identifying the main nasal landmarks. Resection of one,
usually the right, or both middle turbinates is performed.
Additional space is obtained through a middle turbinectomy,
usually on the right side for right-handed surgeons and
lateralization of the contralateral middle turbinate. Once
a bilateral nostril approach is created, the nasoseptal flap
can be harvested. This pedicled flap can be used in the
multilayer reconstruction of the osteodural defect after
the extended approach.
nasoseptal artery, a branch of the sphenopalatine artery,
which can be identified above the choana. The right
uncinate process is then resected, and a middle meatal
antrostomy is performed to reflect a nasoseptal flap into
the maxillary sinus. The maxillary antrostomy is performed
to aid surgical orientation and to allow more lateral routes,
such as the paramedian approach. Depending on the
surgical approach, the flap can be rotated into the maxillary
sinus or be pushed backward to the rhinopharynx. To
gain access to the rhinopharyngeal segment of the clivus,
the vomer and the sphenoidal floor must be removed
(Fig. 29.11). At the level of the caudal part of the vomer, the
mucosa is dissected to identify the vomer–sphenoid junction
and, laterally, the pterygoid canal and the vidian nerve
30
The initial step of the procedure starts with
31–34
Its vascular peduncle is the
308
Far Lateral-Craniovertebral Approach
https://t.me/med1917
Fig. 29.10 Anatomic picture
showing the dissection of the
main neurovascular structures.
fl
VII
cp
C
PICA
XII
AICA
IX
X
JT
XI
JF
AICA, anterior inferior cerebellar
artery; C, cerebellum; C2dr, second
cervical dorsal root; cp, choroid
plexus; DL, dentate ligament; Dm,
dura mater; fl , fl occulus; JF, jugular
foramen; JT, jugular tubercle; PICA,
posterior inferior cerebellar artery;
PMA, posterior meningeal artery;
PSA, posterior spinal artery; VA,
vertebral artery; VII, facial nerve; IX,
glossopharyngeal nerve; X, vagus
nerve; XI, accessory nerve; XII,
hypoglossal nerve.
dm
a
Fig. 29.11 Endoscopic endonasal view after a wide anterior sphenoidotomy (a) and the complete clivectomy (b). aom,
atlantooccipital membrane; C, clivus ; C1, atlas; CP, carotid protuberance; dm, dura mater; ET, eustachian tubes; iwsphs, inferior wall
of the sphenoid sinus; ICAc, paraclival segment of the internal carotid artery; ICAs, sellar segment of the internal carotid artery; MT,
middle turbinate; PG, pituitary gland; SF, sellar fl oor.
PMA
PSA
DL
C2dr
CP CP
SF
C
iwsphs
ET
aom
ET
MT
VA
ICAs
ICAc
ET
b
PG
dm
C1
ICAs
ICAc
MT
ET
(Fig. 29.12), whose variable course has been previously
described.
15
During the endonasal approach to the clivus, the
vomer–sphenoid junction is the first consistent landmark
to be identified when the mucosa is dissected from the
inferior wall of the sphenoid sinus. The pterygoid canal
can be followed during removal of the sphenoidal floor and
steered toward the anterior genu of the intrapetrous carotid
artery; by drilling the bone inferomedially to this canal, the
surgical corridor can be expanded laterally, reducing the
risk of injury to the internal carotid artery (Fig. 29.12). After
removal of the entire clival recess, the rhinopharyngeal
segment of the clivus is exposed down to the level of the
eustachian tubes (Fig. 29.11).
Transclival Approach: Midline and
Paramedian Exposure
After the dissection of the rhinopharyngeal mucosa and
the disinsertion of the longus capitis muscle from the
occipital bone, the clival bone is removed down to the
anterior arch of the atlas, which represents the inferior
limit of the approach. Removal of the clival bone is
initiated with a diamond burr and continued carefully
with a Kerrison punch. The clivus is drilled from the
floor of the sphenoid sinus down to the basion. The
superolateral limit of the clivectomy is the foramen
lacerum and the inferolateral limit is represented by C1,
309
Far Lateral-Craniovertebral Approach
https://t.me/med1917
PG
ICAc
dm
fl
vn
JT
C1
Fig. 29.12 Endoscopic endonasal view of the transclival
approach. C1, atlas; dm, dura mater; fl , foramen lacerum; ICAc,
paraclival segment of the internal carotid artery; JT, jugular
tubercle; PG, pituitary gland; vn, vidian nerve.
ICAc
fl
vn
JT
the medial aspect of the occipital condyle (Fig. 29.12). To
gain a lateral extension, the supracondylar region, which
represents the ventral aspect of the jugular tubercle,
is drilled laterally with the aid of a 45-degree rod-lens
endoscope (Fig. 29.12).
Intradural Exposure
Dura opening should be performed at the midline
(Fig. 29.13), after locating the position of the internal
carotid arteries on both sides and the basilar artery with
image guidance and micro-Doppler. Once the ventral
inferior clivus is drilled, the underlying dura mater and
its basilar venous plexus are exposed. The opening of
PG
ICAc
ICAc
Fig. 29.13 Endoscopic endonasal view, opening of the dura
mater. BA, basilar artery; dm, dura mater; ICAc, paraclival
segment of the internal carotid artery; PG, pituitary gland.
BA
dm
the clival dura continues downward along the midline
and is then reflected laterally on each side. At this point,
the endonasal working area is completely exposed:
the vertebral arteries are dissected and the cisternal
segments of the abducens and hypoglossal nerves are
identified. The sequence for intradural dissection in this
segment begins with the identification of the basilar
artery, the posterior cerebral arteries, and the superior
cerebellar artery just above the oculomotor nerve
(Fig. 29.14) The abducens and the trigeminal nerves can
be identified immediately rostral to the vertebrobasilar
junction bilaterally (Fig. 29.15). After that, the vertebral
arteries along their cisternal course are identified up to
the vertebrobasilar junction; cranial nerves IX, X, and
XI are visualized from their origin at the medulla, on
PcoA
III
Fig. 29.14 Endoscopic endonasal view of the interpeduncular
cistern. BA, basilar artery; LM, Liliequist’s membrane; MB,
mammillary body; PCA, posterior cerebral artery; PcoA,
posterior communicating artery; SCA, superior cerebellar
artery; III, oculomotor nerve.
310
SCA
MB
BA
PCA
III
LM
III
V
VI
AICA
Fig. 29.15 Endoscopic endonasal view of the prepontine
cistern. III, oculomotor nerve; V, trigeminal nerve; VI, abducens
nerve; AICA, anterior inferior cerebellar artery; BA, basilar artery;
PCA, posterior cerebral artery; SCA, superior cerebellar artery.
PCA
SCA
BA
Far Lateral-Craniovertebral Approach
https://t.me/med1917
VII.VIII
CP
IX
XII
X
JF
XI
XI
OC
Hc
IO
ALS
Fig. 29.16 Endoscopic endonasal view of the lower cranial
nerves. ALS, anterolateral sulcus; CP, carotid plexus; Hc,
hypoglossal canal; IO, inferior olive; JF, jugular foramen; OC,
occipital condyle; VII, facial nerve; VIII, vestibulocochlear nerve;
IX, glossopharyngeal nerve; X, vagus nerve; XI, accessory
nerve; XII, hypoglossal nerve.
their way toward the jugular foramen. The hypoglossal
nerve is identified, arising in the pre-olivary sulcus and
direct forward and laterally through the subarachnoid
space (Fig. 29.16). Finally, a panoramic view of the entire
midline exposure can be achieved (Fig. 29.17).
29.2.3 Combined Far Lateral
and Endonasal Craniovertebral
Approach
A combined access to the ventromedial and dorsolateral
compartments can be achieved upon completion of both
the endoscopic endonasal far medial approach and the
transcondylar far lateral approach. Lower cranial nerves
are the natural boundaries limiting the communication
between the ventromedial and the dorsolateral
compartments. The combination of a transcranial
and endoscopic endonasal routes skips this anatomic
limitation by approaching the posterior fossa through
natural complementary corridors. This strategy allows
accessing most of the lower brainstem while avoiding
cranial nerve manipulation. It affords an extension of
visualization and access to the lower third of the pons and
the medulla oblongata.
29.2.4 Case Example
A 45-year-old female patient was admitted to our
hospital with a 3-month history of headache, nausea,
and vomiting. She had also experienced diplopia, orbital
pain, and gaze disturbance. Neurologic examination
revealed palsy of the left sixth cranial nerve. Results of
other hematologic, biochemical, and urine examinations
were normal. Magnetic resonance imaging (MRI)
ON
ICAs
ICAc
FL BA
ET ET
Fig. 29.17 Endoscopic endonasal panoramic view of the
entire midline skull base. BA, basilar artery; Ch, optic chiasm;
ET, eustachian tubes; FL, foramen lacerum; ICAc, paraclival
segment of the internal carotid artery; ICAs, sellar segment of
the internal carotid artery; ON, optic nerve; PG, pituitary gland;
VA, vertebral artery.
showed a contrast-enhancing mass in the lower portion
of the clivus extending to the left cerebellopontine angle
(Fig. 29.18).
The patient underwent a combined far lateral and
endonasal clival-craniovertebral approach in two
surgical stages. Postoperatively, she had a marked
improvement of diplopia, resolution of headaches, and
no additional neurologic defect. She was discharged
from the hospital 10 days later. Postoperative MRI after
3 months showed a gross total resection of the tumor
and the two routes of the combined surgical approaches
(Fig. 29.19).
Ch
PG
VA
ON
ICAs
ICAc
FL
29.2.5 Complications
Concerning the far lateral approach, there are some
drawback routes, especially for intradural lesions. The
lateral extension is limited by the vertebral arteries
and the jugular vein. Potential complications include
possible vertebral artery injury and occipitocervical
instability, if the anterior third of the occipital condyle
has been drilled out. In many cases, the tumor is
encountered first and the lesion–brainstem plane is
approached “blindly” at the end of the procedure. In
such cases, neurologic complications include cranial
nerve injuries and vascular complications that affect
the brain stem. The location of the tumor determines
which cranial nerves are at risk. Stretch or traction
injury, thermal injury due to electrocautery, or sharp
transection of nerves can occur using both open
transcranial or endonasal routes. Injury to the lower
cranial nerves (IX, X, XI, XII), especially in meningiomas
of the foramen magnum and chordomas of the lower
clivus that grow nearby these nerves, can produce
difficulty in swallowing with an increased risk of
developing a postoperative aspiration pneumonia.
311
Far Lateral-Craniovertebral Approach
https://t.me/med1917
dm
VA
ab
SF
CPs
ICAc
c
Fig. 29.18 Illustrative case: patient positioning and skin incision for the far lateral approach (a). Far lateral approach: suboccipital
craniotomy and exposure of the dura mater (b). Endoscopic endonasal transclival approach: the main anatomic landmarks before
tumor resection (c), and panoramic view after tumor removal and exposure of the basilar artery. BA, basilar artery; C, clivus; CPs, carotid
protuberances; dm, dura mater; ICAc, paraclival segment of the internal carotid artery; SF, sellar fl oor; T, tumor; VA, vertebral artery.
Concerning the endonasal craniovertebral approach,
along with managing complex neurovascular
structures, the repair of a large skull base defect
resulting from extensive drilling of the skull base
remains a difficult challenge. Problems with closure
of the dura mater and prevention of CSF leaks are
a persistent source of infectious complications in
both endoscopic and open approaches to intradural
anterolateral brainstem lesions. Other endonasal
approach–related complications to be considered are
chronic sinusitis from infection, mucocele, loss of sinus
mucociliary transport, and persistent crusting of the
nasal cavities.
SF CPs
C
T
BA
ICAc
ICAc
d
working angle is adequate for different lateral brainstem
tumors and can be extended by drilling the posterior
third of the occipital condyle with satisfactory results.
In contrast, the management of lesions situated in the
anterior or anterolateral part of the foramen magnum is
highly challenging, as it is associated with high morbidity
and mortality. In such cases, a posterolateral exposure
can be insufficient and may be hazardous.
As a matter of fact, the ventral endonasal route can be
considered the safest route for the removal of ventrally
located tumors at the foramen magnum as it provides
a direct and “natural” route to the pathology, without
having to work around the brain stem and neurovascular
structures.
Surgical planning is key for a successful procedure,
29.2.6 Tips and Tricks
The far lateral approach is a versatile and safe approach
for anterior and anterolateral foramen magnum lesions
with acceptable rate of risk and complications. The
and the choice of the best surgical approach must be
done after weighing the relative risk/benefit ratio of each
corridor.
Another important factor is detailed knowledge of the
anatomy of vessels and nerves plane by plane. Anatomy
dm
312
Far Lateral-Craniovertebral Approach
https://t.me/med1917
ab
Fig. 29.19 Preoperative (a) and postoperative (b) magnetic resonance imaging showing surgical results after a combined far lateral
and endonasal clival–craniovertebral approach in two diff erent surgical steps (blue arrows).
plays a critical role when performing surgery to avoid
complications and to contribute to the development of a safe
and reproducible surgical access in such complex regions.
Subsequently, intraoperative cranial nerve monitoring
is essential to alert the surgeon when nerves are at risk,
especially when the lesion grows near or encases major
neurovascular structures. Actually, cranial nerves II to XII
can be monitored intraoperatively, and it is mandatory in
this kind of surgery.
The goal of modern skull base surgery is to debulk the
tumor as much as possible while preserving the quality
of life of the patient. A first gross total removal strategy
is becoming increasingly popular for petroclival lesions
possibly followed by, when indicated, radiotherapy or
stereotactic radiosurgery of the residual tumor.
References
1. Feigl GC, Bundschuh O, Gharabaghi A, et al. Evaluation of a new
concept for the management of skull base chordomas and chondrosarcomas. J Neurosurg 2005;102(Suppl):165–170
2. Gay E, Sekhar LN, Rubinstein E, et al. Chordomas and chondrosarcomas of the cranial base: results and follow-up of 60 patients.
Neurosurgery 1995;36(5):887–896, discussion 896–897
3. Herold C, Giordano M, Naka T, Gerganov V, Samii M, Samii A. Clivus chordoma in continuity with a large pontine cyst. Skull Base
2009;19(2):177–181
4. Laws E. Clivus chordomas. In: Sekhar LN, Janecka IP, eds. Surgery
of Cranial Base Tumors. New York, NY: Raven Press; 1993:679–685
5. Crumley RL, Gutin PH. Surgical access for clivus chordoma. The
University of California, San Francisco, experience. Arch Otolaryngol Head Neck Surg 1989;115(3):295–300
6. Guan MW, Wang JY, Feng DX, et al. Anatomical study of endoscope-assisted far lateral keyhole approach to the ventral craniocervical region with neuronavigational guidance. Chin Med J
(Engl) 2013;126(9):1707–1713
7. Kawashima M, Tanriover N, Rhoton AL Jr, Ulm AJ, Matsushima
T. Comparison of the far lateral and extreme lateral variants of
the atlanto-occipital transarticular approach to anterior extradural lesions of the craniovertebral junction. Neurosurgery
2003;53(3):662–674, discussion 674–675
8. Couldwell WT, Weiss MH, Rabb C, Liu JK, Apfelbaum RI, Fukushima T. Variations on the standard transsphenoidal approach to the
sellar region, with emphasis on the extended approaches and
parasellar approaches: surgical experience in 105 cases. Neurosurgery 2004;55(3):539–547, discussion 547–550
9. Cavallo LM, Messina A, Cappabianca P, et al. Endoscopic endonasal
surgery of the midline skull base: anatomical study and clinical
considerations. Neurosurg Focus 2005;19(1):E2
10. Fraser JF, Nyquist GG, Moore N, Anand VK, Schwartz TH.
Endoscopic endonasal minimal access approach to the clivus:
case series and technical nuances. Neurosurgery 2010;67(3, Suppl
Operative):150–158, discussion 158
11. Barges-Coll J, Fernandez-Miranda JC, Prevedello DM, et al.
Avoiding injury to the abducens nerve during expanded
endonasal endoscopic surgery: anatomic and clinical case studies.
Neurosurgery 2010;67(1):144–154, discussion 154
12. Kassam AB, Prevedello DM, Carrau RL, et al. The front door to
meckel’s cave: an anteromedial corridor via expanded endoscopic endonasal approach- technical considerations and clinical series. Neurosurgery 2009; 64(3, Suppl):ons71–ons82, discussion
ons82–ons83
13. Prevedello DM, Pinheiro-Neto CD, Fernandez-Miranda JC, et
al. Vidian nerve transposition for endoscopic endonasal middle fossa approaches. Neurosurgery 2010; 67(2, Suppl Operative):478–484
14. d’Avella E, Angileri F, de Notaris M, et al. Extended endoscopic
endonasal transclival approach to the ventrolateral brainstem
and related cisternal spaces: anatomical study. Neurosurg Rev
2014;37(2):253–260, discussion 260
15. de Notaris M, Cavallo LM, Prats-Galino A, et al. Endoscopic endonasal transclival approach and retrosigmoid approach to the clival
and petroclival regions. Neurosurgery 2009; 65(6, Suppl):42–50,
discussion 50–52
16. de Notaris M, Esposito I, Cavallo LM, et al. Endoscopic endonasal
approach to the ethmoidal planum: anatomic study. Neurosurg
Rev 2008;31(3):309–317
313
Far Lateral-Craniovertebral Approach
https://t.me/med1917
17. Solari D, Chiaramonte C, Di Somma A, et al. Endoscopic anatomy of
the skull base explored through the nose. World Neurosurg 2014;
82(6, Suppl):S164–S170
18. Jho HD. Endoscopic endonasal skull base surgery for midline lesions from olfactory groove to distal clivus. In: 67th Annual Meeting of the American Association of Neurological Surgeons, New
Orleans, LA; 1999
19. Di Somma A, de Notaris M, Ensenat J, et al. The ventral route to
intracranial aneurysm: from the origin towards modern transsphenoidal surgery. An historical review and current perspective.
Rhinology 2014;52(3):195–207
20. Enseñat J, Alobid I, de Notaris M, et al. Endoscopic endonasal clipping of a ruptured vertebral-posterior inferior cerebellar artery
aneurysm: technical case report. Neurosurgery 2011; 69(1, Suppl
Operative):E121–E127, discussion E127–E128
21. Fraser JF, Nyquist GG, Moore N, Anand VK, Schwartz TH. Endoscopic endonasal transclival resection of chordomas: operative
technique, clinical outcome, and review of the literature. J Neurosurg 2010;112(5):1061–1069
22. Jho HD, Ha HG. Endoscopic endonasal skull base surgery: Part
3—The clivus and posterior fossa. Minim Invasive Neurosurg
2004;47(1):16–23
23. Kassam AB, Gardner PA, Snyderman CH, Carrau RL, Mintz AH,
Prevedello DM. Expanded endonasal approach, a fully endoscopic
transnasal approach for the resection of midline suprasellar craniopharyngiomas: a new classification based on the infundibulum. J Neurosurg 2008;108(4):715–728
24. Stippler M, Gardner PA, Snyderman CH, Carrau RL, Prevedello DM,
Kassam AB. Endoscopic endonasal approach for clival chordomas.
Neurosurgery 2009;64(2):268–277, discussion 277–278
25. Benet A, Prevedello DM, Carrau RL, et al. Comparative analysis of
the transcranial “far lateral” and endoscopic endonasal “far medial” approaches: surgical anatomy and clinical illustration. World
Neurosurg 2014;81(2):385–396
26. Morera VA, Fernandez-Miranda JC, Prevedello DM, et al. “Far-medial” expanded endonasal approach to the inferior third of the
clivus: the transcondylar and transjugular tubercle approaches.
Neurosurgery 2010; 66(6, Suppl Operative):211–219, discussion
219–220
27. Sekhar LN, Tariq F, Osbun J. Far lateral and far medial approaches to
the foramen magnum: microsurgery or endoscopy? World Neurosurg 2014;81(2):283–284
28. Simal-Julián JA, Miranda-Lloret P, Beltrán-Giner A, Plaza-Ramirez
E, Botella-Asunción C. Full endoscopic endonasal extreme far-medial approach: Eustachian tube transposition. J Neurosurg Pediatr
2013;11(5):584–590
29. Solari D, Cappabianca P. Far medial versus far lateral approach: the
need of a chamaleontic perspective to unlock a skull base region.
World Neurosurg 2014;81(2):279–280
30. 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(1):E4
31. Fortes FS, Carrau RL, Snyderman CH, et al. Transpterygoid transposition of a temporoparietal fascia flap: a new method for skull base
reconstruction after endoscopic expanded endonasal approaches.
Laryngoscope 2007;117(6):970–976
32. Fortes FS, Carrau RL, Snyderman CH, et al. The posterior pedicle
inferior turbinate flap: a new vascularized flap for skull base reconstruction. Laryngoscope 2007;117(8):1329–1332
33. Hadad G, Bassagasteguy L, Carrau RL, et al. A novel reconstructive technique after endoscopic expanded endonasal
approaches: vascular pedicle nasoseptal flap. Laryngoscope
2006;116(10):1882–1886
34. Kassam AB, Thomas A, Carrau RL, et al. Endoscopic reconstruction of the cranial base using a pedicled nasoseptal flap.
Neurosurgery 2008; 63(1, Suppl 1):ONS44–ONS52, discussion
ONS52–ONS53
314
Соседние файлы в папке Библиотека им академика М.И. Перельмана