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

Autor: Shkarubo AN; Department of Neurooncology, Federal State Autonomous Institution, N. N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russia., Koval KV; Department of Neurooncology, Federal State Autonomous Institution, N. N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russia., Shkarubo MA; Department of Neurooncology, Federal State Autonomous Institution, N. N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russia., Chernov IV; Department of Neurooncology, Federal State Autonomous Institution, N. N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russia. Electronic address: ichernov@nsi.ru., Andreev DN; Department of Neurooncology, Federal State Autonomous Institution, N. N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russia., Panteleyev AA; Department of Spinal Pathology, N. N. Priorov Central Institute of Traumatology and Orthopedics, Moscow, Russia.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2018 Nov; Vol. 119, pp. e825-e841. Date of Electronic Publication: 2018 Aug 07.
DOI: 10.1016/j.wneu.2018.07.275
Abstrakt: 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.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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