Techniques and challenges of the expanded endoscopic endonasal access to the ventrolateral skull base during the "far-medial" and "extreme medial" approaches.
Acta Neurochir (Wien)
; 162(3): 597-603, 2020 03.
Article
em En
| MEDLINE
| ID: mdl-31932986
ABSTRACT
BACKGROUND:
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.METHODS:
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.CONCLUSION:
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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Condrossarcoma
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Neoplasias da Base do Crânio
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Procedimentos Neurocirúrgicos
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Traumatismos dos Nervos Cranianos
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Dissecação
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Cirurgia Endoscópica por Orifício Natural
Limite:
Humans
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article