Endonasal and Transoral Approaches to the Craniovertebral Junction: A Quantitative Anatomical Study

2019 ◽  
pp. 37-44 ◽  
Author(s):  
Francesco Doglietto ◽  
Francesco Belotti ◽  
Jimmy Qiu ◽  
Elena Roca ◽  
Ivan Radovanovic ◽  
...  
Keyword(s):  
Anatomical Study ◽  
Craniovertebral Junction

Feasible and Accurate Occipitoatlantal Transarticular Fixation: An Anatomic Study

2010 ◽  
Vol 66 (suppl_1) ◽  
pp. ons-173-ons-177 ◽  
Author(s):  
Mehmet Senoglu ◽  
Sam Safavi-Abbasi ◽  
Nicholas Theodore ◽  
Neil R. Crawford ◽  
Volker K.H. Sonntag
Keyword(s):  
Anatomical Study ◽  
Craniovertebral Junction ◽  
Screw Placement ◽  
Occipital Condyle ◽  
X Rays ◽  
Anatomic Study ◽  
Screw Insertion ◽  
Computed Tomographic ◽  
Entry Points ◽  
Transarticular Fixation

Abstract Background: Defining the anatomic zones for the placement of occiput-C1 transarticular screws is essential for patient safety. Objective: The feasibility and accuracy of occiput-C1 transarticular screw placement were evaluated in this anatomical study of normal cadaveric specimens. Material and Methods: Sixteen measurements were determined for screw entry points, trajectories, and lengths for placement of transarticular screws, as applied in the technique described by Grob, on the craniovertebral junction segments (occiput-C2) of 16 fresh human cadaveric cervical spines and 41 computed tomographic reconstructions of the craniovertebral junction. Acceptable angles for screw positioning were measured on digital x-rays. Results: All 32 screws were placed accurately. As determined by dissection of the specimens, none of the screws penetrated the spinal canal. Screw insertion caused no fractures, and the integrity of the hypoglossal canal was maintained in all the disarticulated specimens. Conclusion: Viable transarticular occiput-C1 screw placement is possible, despite variability of the anatomy of the occipital condyle.

Microsurgical Anatomy of the Hypoglossal Nerve in the Lateral Approaches to the Craniovertebral Junction: A Study on Fresh Non-Formalin-Fixed Human Specimens

2022 ◽  
Author(s):  
Lorenzo Pescatori ◽  
Maria Pia Tropeano ◽  
Manolo Piccirilli ◽  
Pasqualino Ciappetta
Keyword(s):  
Hypoglossal Nerve ◽  
Anatomical Study ◽  
Craniovertebral Junction ◽  
Lateral Approach ◽  
Anterolateral Approach ◽  
Microsurgical Anatomy ◽  
Arteries And Veins ◽  
Formalin Fixed

AbstractThe aim of this anatomical study is to describe the anatomy of the hypoglossal nerve (HN) from its origin to the extracranial portion as it appears by performing a combined posterolateral and anterolateral approach to the craniovertebral junction (CVJ). Twelve fresh, non-formalin-fixed adult cadaveric heads (24 sides) were analyzed for the simulation of the combined lateral approach to the CVJ. The HN is divided into three main parts: cisternal, intracanalicular, and extracranial The anatomical relationships between the HN and other nerves, muscles, arteries and veins were carefully recorded, and some measurements were made between the HN and related structures. Thus, various landmarks were determined for the easy identification of the HN. Understanding the detailed anatomy of the HN and its relationships with the surrounding structures is crucial to prevent some complications during CVJ surgery.

scholarly journals The endoscopic transoral approach to the craniovertebral junction: an anatomical study with a clinical example

2016 ◽  
Vol 40 (2) ◽  
pp. E11 ◽  
Author(s):  
Andrew K. Chan ◽  
Arnau Benet ◽  
Junichi Ohya ◽  
Xin Zhang ◽  
Todd D. Vogel ◽  
...  
Keyword(s):  
Anatomical Study ◽  
Linear Measurement ◽  
Craniovertebral Junction ◽  
Transoral Approach ◽  
Velopharyngeal Insufficiency ◽  
Measurement Tool ◽  
Splitting Technique ◽  
Soft Tissue Dissection ◽  
Expanded Endonasal Approach ◽  
The Right

OBJECTIVE The microscopic transoral, endoscopic transnasal, and endoscopic transoral approaches are used alone and in combination for a variety of craniovertebral junction (CVJ) pathologies. The endoscopic transoral approach provides a more direct exposure that is not restricted by the nasal cavity, pterygoid plates, and palate while sparing the potential morbidities associated with extensive soft-tissue dissection, palatal splitting, or mandibulotomy. Concerns regarding the extent of visualization afforded by the endoscopic transoral approach may be limiting its widespread adoption. METHODS A dissection of 10 cadaver heads was undertaken. CT-based imaging guidance was used to measure the working corridor of the endoscopic transoral approach. Measurements were made relative to the palatal line. The built-in linear measurement tool was used to measure the superior and inferior extents of view. The superolateral extent was measured relative to the midline, as defined by the nasal process of the maxilla. The height of the clivus, odontoid tip, and superior aspect of the C-1 arch were also measured relative to the palatal line. A correlated clinical case is presented with video. RESULTS The CVJ was accessible in all cases. The superior extent of the approach was a mean 19.08 mm above the palatal line (range 11.1–27.7 mm). The superolateral extent relative to the midline was 15.45 mm on the right side (range 9.6–23.7 mm) and 16.70 mm on the left side (range 8.1–26.7 mm). The inferior extent was a mean 34.58 mm below the palatal line (range 22.2–41.6 mm). The mean distances were as follows: palatal line relative to the odontoid tip, 0.97 mm (range −4.9 to 3.7 mm); palatal line relative to the height of the clivus, 4.88 mm (range −1.5 to 7.3 mm); and palatal line relative to the C-1 arch, −2.75 mm (range −5.8 to 0 mm). CONCLUSIONS The endoscopic transoral approach can reliably access the CVJ. This approach avoids the dissections and morbidities associated with a palate-splitting technique (velopharyngeal insufficiency) and the expanded endonasal approach (mucus crusting, sinusitis, and potential lacerum or cavernous-paraclival internal carotid artery injury). For appropriately selected lesions near the palatal line, the endoscopic transoral approach appears to be the preferred approach.

Endonasal Endoscopic and Transoral Approaches to the Craniovertebral Junction and the Clival Region: A Comparative Anatomical Study

2019 ◽  
Vol 132 ◽  
pp. e116-e123
Author(s):  
Alfio Spina ◽  
Filippo Gagliardi ◽  
Javier Abarca-Olivas ◽  
Michele Bailo ◽  
Nicola Boari ◽  
...  
Keyword(s):  
Anatomical Study ◽  
Craniovertebral Junction

The Extreme Lateral Approach to the Craniovertebral Junction: An Anatomical Study

2019 ◽  
pp. 175-178
Author(s):  
Francesco Signorelli ◽  
Walter Pisciotta ◽  
Vittorio Stumpo ◽  
Pasquale Ciappetta ◽  
Alessandro Olivi ◽  
...  
Keyword(s):  
Anatomical Study ◽  
Craniovertebral Junction ◽  
Lateral Approach

Endoscopic far-lateral approach to the posterolateral craniovertebral junction: an anatomical study

2012 ◽  
Vol 36 (2) ◽  
pp. 239-247 ◽  
Author(s):  
Fuminari Komatsu ◽  
Mika Komatsu ◽  
Antonio Di Ieva ◽  
Manfred Tschabitscher
Keyword(s):  
Anatomical Study ◽  
Craniovertebral Junction ◽  
Lateral Approach ◽  
Far Lateral Approach ◽  
Far Lateral

scholarly journals Craniovertebral junction 360°: A combined microscopic and endoscopic anatomical study

2016 ◽  
Vol 7 (4) ◽  
pp. 204 ◽  
Author(s):  
SukhdeepSingh Jhawar ◽  
Maximiliano Nunez ◽  
Paolo Pacca ◽  
DanielSeclen Voscoboinik ◽  
Huy Truong
Keyword(s):  
Anatomical Study ◽  
Craniovertebral Junction

Surgical Strategies in Craniovertebral Junction Lesions

2012 ◽  
Vol 73 (S 02) ◽  
Author(s):  
Y. Shulev ◽  
V. Stepanenko ◽  
A. Trashin
Keyword(s):  
Craniovertebral Junction ◽  
Surgical Strategies
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