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内镜辅助下经高颈段咽后外侧入路至斜坡：一项尸体研究

Endoscopy-assisted high cervical anterolateral retropharyngeal approach to clivus: a cadaveric study.

作者信息

Cicek Caner, Orhun Ömer, Cevik Orhun Mete, Rzayeva Lala, Güdük Mustafa, Usseli Murat İmre, Aksoy Mehmet Emin, Emel Erhan, Pamir M Necmettin, Bozkurt Baran

机构信息

Department of Neurosurgery, Zonguldak State Hospital, Zonguldak, Türkiye.

Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Türkiye.

出版信息

Front Surg. 2024 Jul 22;11:1397729. doi: 10.3389/fsurg.2024.1397729. eCollection 2024.

DOI:10.3389/fsurg.2024.1397729
PMID:39104713
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11298333/
Abstract

INTRODUCTION

The surgical management of pathologies involving the clivus and craniocervical junction has always been considered a complex procedure because of the deeply located surgical targets and the surrounding complex neural and vascular anatomical structures. The most commonly used approaches to reach this area are the transnasal, transoral, and transcervical approaches.

MATERIAL AND METHODS

This approach was performed unilaterally on five cadaver heads and bilaterally on one cadaver head.

RESULTS

We described a modified endoscope-assisted high cervical anterolateral retropharyngeal approach in which each stage of the procedure was demonstrated on human cadavers in a step-by-step manner using endoscopic camera views. This approach was broken down into nine steps. The neurovascular structures encountered at each step and their relationships with each other are demonstrated.

DISCUSSION

The advantages and disadvantages of our modified approach were compared to the conventional transcervical, transoral, and endoscopic endonasal approaches.

摘要

引言

由于手术靶点位置深且周围神经和血管解剖结构复杂，涉及斜坡和颅颈交界区病变的外科治疗一直被认为是一项复杂的手术。到达该区域最常用的方法是经鼻、经口和经颈入路。

材料与方法

该入路在5个尸头上单侧进行，在1个尸头上双侧进行。

结果

我们描述了一种改良的内镜辅助高位颈前外侧咽后入路，该入路的每个步骤均通过内镜摄像视图在人体尸体上逐步展示。该入路分为九个步骤。展示了每个步骤中遇到的神经血管结构及其相互关系。

讨论

将我们改良入路的优缺点与传统经颈、经口和内镜鼻内入路进行了比较。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c475/11298333/0e029df449ab/fsurg-11-1397729-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c475/11298333/329f33628198/fsurg-11-1397729-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c475/11298333/9a09f053611f/fsurg-11-1397729-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c475/11298333/c99f1fc3fca1/fsurg-11-1397729-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c475/11298333/3463558acd7c/fsurg-11-1397729-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c475/11298333/0e029df449ab/fsurg-11-1397729-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c475/11298333/329f33628198/fsurg-11-1397729-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c475/11298333/9a09f053611f/fsurg-11-1397729-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c475/11298333/c99f1fc3fca1/fsurg-11-1397729-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c475/11298333/3463558acd7c/fsurg-11-1397729-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c475/11298333/0e029df449ab/fsurg-11-1397729-g005.jpg

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本文引用的文献

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Front Surg. 2022 Oct 31;9:984015. doi: 10.3389/fsurg.2022.984015. eCollection 2022.
2
Simplified four-step retropharyngeal approach for the upper cervical spine: technical note.简化的经咽后入路在上颈椎中的应用：技术要点。
Eur Spine J. 2020 Nov;29(11):2752-2757. doi: 10.1007/s00586-020-06521-5. Epub 2020 Jul 9.
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The High Cervical Anterolateral Retropharyngeal Approach.高位颈椎咽后外侧入路
Acta Neurochir Suppl. 2019;125:147-149. doi: 10.1007/978-3-319-62515-7_21.
4
Walk the Line. The Surgical Highways to the Craniovertebral Junction in Endoscopic Approaches: A Historical Perspective.《循规蹈矩。内镜入路中通往颅颈交界区的手术路径：历史视角》
World Neurosurg. 2018 Feb;110:544-557. doi: 10.1016/j.wneu.2017.06.125.
5
Endoscopic Submandibular Retropharyngeal Approach to the Craniocervical Junction and Clivus: an Anatomic Study.内镜下经下颌下后咽入路至颅颈交界区和斜坡：一项解剖学研究。
World Neurosurg. 2017 Oct;106:266-276. doi: 10.1016/j.wneu.2017.06.162. Epub 2017 Jul 8.
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Endoscopic Resection of Clival Malignancies.斜坡恶性肿瘤的内镜下切除术
Otolaryngol Clin North Am. 2017 Apr;50(2):315-329. doi: 10.1016/j.otc.2016.12.008.
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