Department of Anatomy, Medical School of Pernambuco-IMIP, Recife, Brazil.
World Neurosurg. 2010 Aug-Sep;74(2-3):351-8. doi: 10.1016/j.wneu.2010.05.037.
The lateral approach to the craniocervical junction is directed along the atlantal and occipital condyles to the dens. The advantages of the lateral approach compared with the anterior transoral and transnasal approaches are that it provides a sterile field, and anterior decompression and postdecompression fixation can be performed in one procedure.
To examine the usefulness of endoscopy as an auxiliary tool during lateral transatlantal odontoidectomy.
Six cadaver heads, in which the vessels were injected with colored silicone, were dissected using a surgical microscope and 0- and 30-degree endoscopes. A flap incision was chosen to accomplish exposure of the area of the decompression, the occipital squama and adjacent laminae for fixation, and the vertebral artery from C2 to its dural entrance for its stabilization.
Study findings revealed that endoscopy adds several advantages to microscopy in the lateral transatlantal approach to the craniovertebral junction in cases of craniovertebral malformation by providing magnification and illumination not limited by corners, thus helping to avert substandard decompression and complications such as dural tears and cerebrospinal fluid leaks; flexibility in surgical positioning of patients; and improved ergonomics that enable the surgeon to complete the procedure in a more efficient, comfortable, and safe manner.
Endoscopy is a useful adjunct to microscopy in completing lateral approaches to the craniovertebral junction.
颅颈交界区的侧方入路沿寰椎和枕骨髁指向齿突。与经口前路和经鼻前路入路相比，侧方入路的优点是提供了一个无菌区域，并且可以在一次手术中进行前方减压和减压后固定。
探讨内窥镜作为侧方经寰枢椎切除术中辅助工具的实用性。
使用手术显微镜和 0 度和 30 度内窥镜对 6 个头颅标本进行解剖，这些标本的血管用彩色硅酮注射。选择皮瓣切口以完成减压区域、枕骨鳞部和相邻椎板的暴露，用于固定，并稳定 C2 至硬脑膜入口的椎动脉。
研究结果表明，内窥镜在颅颈畸形患者的颅颈交界区侧方经寰枢椎切除术中为显微镜提供了放大和照明，不受拐角限制，从而有助于避免减压不足和硬脑膜撕裂、脑脊液漏等并发症，为患者手术定位提供了灵活性，并改善了手术医生的工作效率，使手术医生能够更高效、舒适和安全地完成手术。
内窥镜是完成颅颈交界区侧方入路的显微镜的有用辅助工具。
