Cárdenas Ruiz-Valdepeñas Eugenio, Kaen Ariel, Pérez Prat Gustavo, Ambrosiani Fernandez Jesus
Department of Neurological Surgery, Hospital Virgen Del Rocío, Avenida Manuel Siurot s/n, 41013, Seville, Spain.
Department of Neurological Surgery, Hospital Vall d'Hebron, Barcelona, Spain.
Acta Neurochir (Wien). 2018 Apr;160(4):741-745. doi: 10.1007/s00701-018-3483-2. Epub 2018 Feb 17.
Nowadays, endoscopic endonasal expanded approach targeting for the clival lower third is well described in literature. Nonetheless, great variations can be found among surgical groups, specially during the earlier stages of this procedure.
We present a step by step description of the clival lower third approach until entering the dural space, setting its bony limits. We describe the basipharyngeal flap tailoring as a helpful option for latter reconstruction. The study of cadaveric specimens adds clarifying dissections.
The expansion in the coronal plane is providential in most of the intradural lesions of the inferior clivus. Basipharyngeal flap may help seal the surgical defects in this area.
如今，针对斜坡下三分之一区域的鼻内镜扩大入路在文献中有详细描述。然而，不同手术团队之间仍存在很大差异，尤其是在该手术的早期阶段。
我们逐步描述斜坡下三分之一入路直至进入硬膜间隙，确定其骨质边界。我们描述了基底咽瓣的修整，作为后期重建的一种有用选择。尸体标本研究增加了清晰的解剖结构。
在大多数斜坡下部硬膜内病变中，冠状面的扩大是很有必要的。基底咽瓣可能有助于封闭该区域的手术缺损。
