Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-24T04:38:28.920Z Has data issue: false hasContentIssue false

Chapter 3 - Combined Endonasal and Transoral Endoscopic Approach to the Craniovertebral Junction

from Section I - Endoscopic Endonasal (EN) Combined Approaches

Published online by Cambridge University Press:  05 October 2021

By
Adam J. Kimple ,
Brian D. Thorp  and
Adam M. Zanation
Edited by
Vijay Agarwal
Get access

Summary

Access to the craniovertebral junction has traditionally been obtained by utilizing transoral approaches; however, the nasal corridor is a useful alternative for direct access to the craniovertebral junction with decreased morbidity. The inferior extent of the endonasal approach is limited by the palate and nasal bones and when this is reached, the caudal extent can be expanded with the combined endonasal-transoral approach. The addition of the transoral corridor allows more caudal access and allows for more complex reconstructions. In this chapter, we discuss a step-wise approach to planning for surgical access of the craniovertebral junction.

Keywords

craniovertebral junctionskull baseendoscopicclivaltransoral
Type
Chapter
Information
Integrated Management of Complex Intracranial Lesions
Open, Endoscopic, and Keyhole Techniques
 , pp. 25 - 28
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rahme, RJ, Arnaout, OM, Sanusi, OR, Kesavabhotla, K, Chandler, JP. Endoscopic approach to clival chordomas: the northwestern experience. World Neurosurg. 2018;110:e231–e8.CrossRefGoogle ScholarPubMed
Labidi, M, Watanabe, K, Bouazza, S, Bresson, D, Bernat, AL, George, B, et al. Clivus chordomas: a systematic review and meta-analysis of contemporary surgical management. J Neurosurg Sci. 2016;60(4):476–84.Google ScholarPubMed
Shah, RN, Surowitz, JB, Patel, MR, Huang, BY, Snyderman, CH, Carrau, RL, et al. Endoscopic pedicled nasoseptal flap reconstruction for pediatric skull base defects. Laryngoscope. 2009;119(6):1067–75.Google ScholarPubMed
Graffeo, CS, Dietrich, AR, Grobelny, B, Zhang, M, Goldberg, JD, Golfinos, JG, et al. A panoramic view of the skull base: systematic review of open and endoscopic endonasal approaches to four tumors. Pituitary. 2014;17(4):349–56.CrossRefGoogle ScholarPubMed
Tan, SH, Ganesan, D, Rusydi, WZ, Chandran, H, Prepageran, N, Waran, V. Combined endoscopic transnasal and transoral approach for extensive upper cervical osteoradionecrosis. Eur Spine J. 2015;24(12):2776–80.CrossRefGoogle ScholarPubMed
Drazin, D, Zhuang, L, Schievink, WI, Mamelak, AN. Expanded endonasal approach for the clipping of a ruptured basilar aneurysm and feeding artery to a cerebellar arteriovenous malformation. J Clin Neurosci. 2012;19(1):144–8.CrossRefGoogle ScholarPubMed
Gempt, J, Lehmberg, J, Grams, AE, Berends, L, Meyer, B, Stoffel, M. Endoscopic transnasal resection of the odontoid: case series and clinical course. Eur Spine J. 2011;20(4):661–6.Google Scholar
Goldschlager, T, Hartl, R, Greenfield, JP, Anand, VK, Schwartz, TH. The endoscopic endonasal approach to the odontoid and its impact on early extubation and feeding. J Neurosurg. 2015;122(3):511–18.CrossRefGoogle Scholar
Lemos-Rodriguez, AM, Sreenath, S, Unnithan, A, Doan, V, Recinos, PF, Zanation, A, et al. A new window for the treatment of posterior cerebral artery, superior cerebellar artery, and basilar apex aneurysm: the expanded endoscopic endonasal approach. J Neurol Surg B Skull Base. 2016;77(4):308–13.Google ScholarPubMed
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.Google Scholar
Seker, A, Inoue, K, Osawa, S, Akakin, A, Kilic, T, Rhoton, AL Jr. Comparison of endoscopic transnasal and transoral approaches to the craniovertebral junction. World Neurosurg. 2010;74(6):583–602.Google Scholar
de Almeida, JR, Zanation, AM, Snyderman, CH, Carrau, RL, Prevedello, DM, Gardner, PA, et al. Defining the nasopalatine line: the limit for endonasal surgery of the spine. Laryngoscope. 2009;119(2):239–44.CrossRefGoogle ScholarPubMed
Mummaneni, PV, Haid, RW. Transoral odontoidectomy. Neurosurgery. 2005;56(5):1045–50.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×