Ventral Surgical Approaches to Craniovertebral Junction Chordomas

Neurosurgery ◽  
2010 ◽  
Vol 66 (suppl_3) ◽  
pp. A96-A103 ◽  
Author(s):  
Harminder Singh ◽  
James Harrop ◽  
Paul Schiffmacher ◽  
Marc Rosen ◽  
James Evans
Keyword(s):  
Surgical Management ◽  
Malignant Tumors ◽  
Craniovertebral Junction ◽  
Transoral Approach ◽  
Operative Approach ◽  
Surgical Approaches ◽  
Transnasal Approach ◽  
Neural Axis ◽  
Endoscopic Transnasal Approach

Abstract BACKGROUND Chordomas are primarily malignant tumors encountered at either end of the neural axis; the craniovertebral junction and the sacrococcygeal junction. In this article, we discuss the surgical management of craniovertebral junction chordomas. OBJECTIVE In this paper, we discuss the surgical management of craniovertebral junction chordomas. RESULTS The following approaches are illustrated: transoral-transpalatopharyngeal approach, high anterior cervical retropharyngeal approach, endoscopic transoral approach, and endoscopic transnasal approach. No single operative approach can be used for all craniovertebral chordomas. Therefore, the location of the tumor dictates which approach or approaches should be used.

scholarly journals Endoscopic Transnasal Odontoidectomy

2020 ◽  
Author(s):  
Cesare Zoia ◽  
Daniele Bongetta ◽  
Sabino Luzzi
Keyword(s):  
Cervical Spine ◽  
Craniovertebral Junction ◽  
Transoral Approach ◽  
Direct Access ◽  
Upper Cervical Spine ◽  
Transnasal Approach ◽  
Adjacent Structures ◽  
Upper Cervical ◽  
Endoscopic Transnasal Approach ◽  
Posterior Ligament

Abstract Background Odontoidectomy may represent the treatment of choice for symptomatic ventral craniovertebral junction stenosis in selected cases. An endoscopic transnasal approach has been proposed as an alternative to a classic transoral approach. Method We report a case of a patient with a craniovertebral junction stenosis due to the ossification of the posterior ligament. The clinical and radiological records of the patient and a step-by-step description of the surgical technique are presented (Fig. 1). Conclusion Endoscopic transnasal odontoidectomy provides a direct access to the dens and adjacent structures of the anterior upper cervical spine with a less invasive burden on the oropharingeal structures.The link to the video can be found at: https://youtu.be/Ofrk1sFTV9I.

Endoscopic Transnasal Resection of Ectopic Esthesioneuroblastoma in the Pterygopalatine Fossa: Technical Case Report

2009 ◽  
Vol 65 (suppl_6) ◽  
pp. onsE112-onsE113 ◽  
Author(s):  
Satoru Kodama ◽  
Toshiaki Kawano ◽  
Masashi Suzuki
Keyword(s):  
Clinical Presentation ◽  
Malignant Tumors ◽  
Malignant Neoplasm ◽  
Complete Removal ◽  
Pterygopalatine Fossa ◽  
Open Approach ◽  
Transnasal Approach ◽  
Olfactory Neuroepithelium ◽  
Endoscopic Transnasal Approach ◽  
Left Maxillary Sinus

Abstract Objective: Esthesioneuroblastoma is a rare, malignant neoplasm arising from the olfactory neuroepithelium in the upper nasal cavity. Even more rare is ectopic esthesioneuroblastoma developing from the region outside the olfactory epithelium. In addition, tumors occurring in the pterygopalatine fossa (PPF) are uncommon, and the endoscopic transnasal approach for the resection of malignant tumors in this region is also uncommon. Clinical Presentation: We describe an esthesioneuroblastoma arising from the left maxillary sinus and PPF. The tumor was resected using the endoscopic transnasal approach, followed by treatment with radiotherapy. The patient showed no evidence of recurrence 12 months postoperatively. Technique: The endoscopic transnasal approach could be successfully used for the complete removal of malignant tumors in the PPF. Conclusion: The PPF is an anatomic area that is difficult to access. The endoscopic transnasal approach improves access and visualization; it also has the potential to reduce complications compared with the open approach. The endoscopic transnasal approach might become the treatment of choice for malignant tumors in the PPF.

Anatomy of anterior craniovertebral junction in endoscopic transnasal approach

2020 ◽  
Vol 84 (4) ◽  
pp. 46
Author(s):  
A.N. Shkarubo ◽  
V.N. Nikolenko ◽  
I.V. Chernov ◽  
D.N. Andreev ◽  
M.A. Shkarubo ◽  
...  
Keyword(s):  
Craniovertebral Junction ◽  
Transnasal Approach ◽  
Endoscopic Transnasal Approach

Transoral and endoscope-assisted transoral approaches to resecting benign tumours of the parapharyngeal space located in the medial portion of the carotid sheaths and extending toward the skull base: our experience

2018 ◽  
Vol 132 (8) ◽  
pp. 748-752 ◽  
Author(s):  
Y Liu ◽  
H-J Yu ◽  
H-T Zhen
Keyword(s):  
Skull Base ◽  
Surgical Management ◽  
Parapharyngeal Space ◽  
Complete Resection ◽  
Transoral Approach ◽  
Surgical Approaches ◽  
Benign Tumours

AbstractObjectiveVarious surgical approaches have been described to remove tumours in the parapharyngeal space. This study investigated the feasibility of a transoral approach in the surgical management of parapharyngeal space benign tumours located in the medial portion of the carotid sheaths and extending toward the skull base.MethodsThirty-two patients were selected and underwent a transoral or an endoscope-assisted transoral approach in the surgical management of parapharyngeal space benign tumours located in the medial portion of the carotid sheaths. Medical photographs were used.ResultsAll patients underwent complete resection of their lesions via a transoral or endoscope-assisted transoral approach. None of the patients demonstrated residual or recurrent neoplasms, either clinically or radiographically, during their follow up.ConclusionBased on our studies, we assert that transoral and endoscope-assisted transoral approaches are suitable in managing parapharyngeal space benign tumours located in the medial portion of the carotid sheaths and extending toward the skull base.

Transnasal odontoid resection followed by posterior decompression and occipitocervical fusion in children with Chiari malformation Type I and ventral brainstem compression

2010 ◽  
Vol 5 (6) ◽  
pp. 549-553 ◽  
Author(s):  
Todd C. Hankinson ◽  
Eli Grunstein ◽  
Paul Gardner ◽  
Theodore J. Spinks ◽  
Richard C. E. Anderson
Keyword(s):  
Chiari Malformation ◽  
Hard Palate ◽  
Transoral Approach ◽  
Comfort Level ◽  
Type I ◽  
Posterior Decompression ◽  
Transnasal Approach ◽  
Chiari Malformation Type I ◽  
Brainstem Compression ◽  
Endoscopic Transnasal Approach

Object In rare cases, children with a Chiari malformation Type I (CM-I) suffer from concomitant, irreducible, ventral brainstem compression that may result in cranial neuropathies or brainstem dysfunction. In these circumstances, a 360° decompression supplemented by posterior stabilization and fusion is required. In this report, the authors present the first experience with using an endoscopic transnasal corridor to accomplish ventral decompression in children with CM-I that is complicated by ventral brainstem compression. Methods Two children presented with a combination of occipital headaches, swallowing dysfunction, myelopathy, and/or progressive scoliosis. Imaging studies demonstrated CM-I with severely retroflexed odontoid processes and ventral brainstem compression. Both patients underwent an endoscopic transnasal approach for ventral decompression, followed by posterior decompression, expansive duraplasty, and occipital-cervical fusion. Results In both patients the endoscopic transnasal approach provided excellent ventral access to decompress the brainstem. When compared with the transoral approach, endoscopic transnasal access presents 4 potential advantages: 1) excellent prevertebral exposure in patients with small oral cavities; 2) a surgical corridor located above the hard palate to decompress rostral pathological entities more easily; 3) avoidance of the oral trauma and edema that follows oral retractor placement; and 4) avoidance of splitting the soft or hard palate in patients with oral-palatal dysfunction from ventral brainstem compression. Conclusions The endoscopic transnasal approach is atraumatic to the oral cavity, and offers a more superior region of exposure when compared with the standard transoral approach. Depending on their comfort level with endoscopic surgical techniques, pediatric neurosurgeons should consider this approach in children with pathological entities requiring ventral brainstem decompression.

Isolated Sphenoid Sinusitis: Problems in Diagnosis and Therapy

1995 ◽  
Vol 9 (4) ◽  
pp. 229-236 ◽  
Author(s):  
Allen M. Seiden
Keyword(s):  
Bacterial Infections ◽  
Sphenoid Sinus ◽  
Fungal Infections ◽  
Surgical Approaches ◽  
Transnasal Approach ◽  
Sinus Disease ◽  
Advantages And Disadvantages ◽  
Sphenoid Sinusitis ◽  
Transseptal Approach ◽  
Endoscopic Transnasal Approach

Isolated sphenoid sinusitis is relatively uncommon and may present with a variety of symptoms. Therefore, it is often misdiagnosed, or detected only when complications develop. As skull base surgery becomes more prevalent, an understanding of sphenoid disease and its manifestations becomes increasingly important. From September 1989 through January 1994, 10 patients were seen with isolated sphenoid sinus disease. All patients presented with atypical headaches. Six had bacterial infections, three had noninvasive fungal infections, and one patient had a sphenoid mucocele. No patient had any recognized risk factors predisposing to such infection. All patients required surgical drainage, which was done through an endoscopic transnasal approach in five, an endoscopic transethmoid approach in three, and a transseptal approach in two, with no surgical complications. The advantages and disadvantages of these approaches compared to more traditional surgical approaches to the sphenoid sinus are discussed.

The Expanded Endonasal Approach: A Fully Endoscopic Transnasal Approach and Resection of the Odontoid Process

Skull Base ◽  
2005 ◽  
Vol 15 (S 2) ◽  
Author(s):  
Carl Snyderman ◽  
Amin Kassam ◽  
Paul Gardner ◽  
Ricardo Carrau ◽  
Richard Spiro
Keyword(s):  
Odontoid Process ◽  
Endonasal Approach ◽  
Transnasal Approach ◽  
Expanded Endonasal Approach ◽  
Endoscopic Transnasal Approach
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