Silveira-Bertazzo Giuliano, Manjila Sunil, London Nyall R, Prevedello Daniel M
Department of Neurological Surgery, The Ohio State University, Wexner Medical Center, N-1049 Doan Hall, 410 West 10th Avenue, Columbus, OH, 43210, USA.
Department of Neurological Surgery, McLaren Hospital, Bay Region, Bay City, MI, USA.
Acta Neurochir (Wien). 2020 Mar;162(3):597-603. doi: 10.1007/s00701-019-04204-9. Epub 2020 Jan 13.
Expanding the ventrolateral skull base corridor from the midline of lower clivus to the petroclival fissure is a challenging endonasal surgical task. Resection of lytic lesions like chondrosarcoma can cause cranial nerve morbidities and injury of ICA, necessitating accurate knowledge of correlative endoscopic anatomy with stereotactic landmarks.
We describe an extended endoscopic endonasal approach (EEA) for a right petroclival chondrosarcoma with the demonstration of ipsilateral surgical landmarks with contralateral normal correlates, using a stepwise comparative image-guided cadaveric dissection study.
EEA for lytic lesions like chondrosarcomas needs to address brain shift and displacement of ICA, posing a chance for cranial nerve morbidities and ICA injury. Meticulous utilization of intraoperative stereotactic landmarks can help avoid and mitigate surgical complications.
将腹外侧颅底通道从下斜坡中线扩展至岩斜裂是一项具有挑战性的鼻内镜手术任务。切除软骨肉瘤等溶骨性病变可导致颅神经病变和颈内动脉损伤，因此需要精确了解相关的内镜解剖结构及立体定向标志。
我们描述了一种用于右侧岩斜软骨肉瘤的扩大鼻内镜经鼻入路（EEA），通过逐步对比图像引导的尸体解剖研究，展示同侧手术标志及对侧正常对照。
对于软骨肉瘤等溶骨性病变的EEA需要应对脑移位和颈内动脉移位，存在颅神经病变和颈内动脉损伤的风险。术中精心利用立体定向标志有助于避免和减轻手术并发症。
