Endoscopic Endonasal Transclival Approach to Tumors of the Clivus and Anterior Region of the Posterior Cranial Fossa: An Anatomic Study

被引：6
|
作者：
Shkarubo, Alexey N. [1 ]
Koval, Konstantin, V [1 ]
Shkarubo, Mikhail A. [1 ]
Chernov, Ilia, V [1 ]
Andreev, Dmitry N. [1 ]
Panteleyev, Andrey A. [2 ]
机构：
[1] Minist Hlth Russian Federat, NN Burdenko Natl Med Res Ctr Neurosurg, Fed State Autonomous Inst, Dept Neurooncol, Moscow, Russia
[2] NN Priorov Cent Inst Traumatol & Orthoped, Dept Spinal Pathol, Moscow, Russia
来源：
WORLD NEUROSURGERY | 2018年 / 119卷
关键词：
Chordoma of clivus; Clivus; Endoscopic endonasal surgery of skull base; Endoscopic endonasal transclival approach; Monitoring of cranial nerves; Posterior cranial fossa; Skull base anatomy; CAVERNOUS SINUS; ABDUCENS NERVE; SKULL BASE; RESECTION; CHORDOMAS;
D O I：
10.1016/j.wneu.2018.07.275
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
OBJECTIVE: To present the basic topographic and anatomic features of the clivus and adjacent structures with an objective of possible improvements and optimization of the extended endoscopic endonasal posterior (transclival) approach when removing tumors of the clivus and anterior regions of the posterior cranial fossa. MATERIALS AND METHODS: A craniometric study was conducted on 125 human skulls. A topographic anatomic study was conducted on 25 cadaver head specimens with arterial and venous beds stained with colored silicone, according to the method developed by us, to visualize its features and individual variability. RESULTS: The most important anatomic features of the external and internal regions of the clivus and the adjacent neural and vascular structures were analyzed. An accessible zone for the most effective transclival approach to the posterior cranial fossa is also specified. CONCLUSION: The endoscopic endonasal transclival approach can be used to obtain access to centrally located tumors of the posterior cranial fossa. It is an alternative to transcranial approaches in the surgical treatment of tumors of the clivus.
引用
收藏
页码：E825 / E841
页数：17
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