The follow-up period ranged from 12 to 50 months.CONCLUSION: Although the microscopic transoral approach has been considered the gold standard for craniovertebral junctionsurgical management, endoscopic approaches are feasible, safe, and effective for addressing pathologies in this region, withdeveloping technique and surgical experience.
📌 3 Maddede Bu Makale
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Amaç & Hipotez:AIM: To review our experience of using the endoscopic endonasal approach for clivus and odontoid pathologies as well ascraniovertebral junction anomalies at our institution.MATERIAL and METHODS: We retrospectively evaluated 41 patients (21 male, 20 female; age range, 2–65 years) who underwentendoscopic endonasal procedures for craniovertebral junction pathologies between 2008 and 2017.RESULTS: Of the 41 patients, 27 had clivus lesions, 7 had odontoid lesions, 6 had basilar invagination, and 1 had rhinorrhea repair.Six patients underwent an additional posterior decompression/fusion either before or after the endonasal procedure.
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Temel Bulgular & Veri:The patients’ meanmodified Rankin scale and visual analog scale scores were 3 and 4, respectively.
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Sonuç & Katkı:The follow-up period ranged from 12 to 50 months.CONCLUSION: Although the microscopic transoral approach has been considered the gold standard for craniovertebral junctionsurgical management, endoscopic approaches are feasible, safe, and effective for addressing pathologies in this region, withdeveloping technique and surgical experience.
🔬Tür:Literatür & Derleme Çalışması
📍Kapsam:2008 Verileri
⚙️Değişkenler:Alan Parametreleri
Özet
AIM: To review our experience of using the endoscopic endonasal approach for clivus and odontoid pathologies as well ascraniovertebral junction anomalies at our institution.MATERIAL and METHODS: We retrospectively evaluated 41 patients (21 male, 20 female; age range, 2–65 years) who underwentendoscopic endonasal procedures for craniovertebral junction pathologies between 2008 and 2017.RESULTS: Of the 41 patients, 27 had clivus lesions, 7 had odontoid lesions, 6 had basilar invagination, and 1 had rhinorrhea repair.Six patients underwent an additional posterior decompression/fusion either before or after the endonasal procedure. None of thepatients required tracheostomy, and cerebrospinal fluid leakage was postoperatively detected in one patient. The patients’ meanmodified Rankin scale and visual analog scale scores were 3 and 4, respectively. The follow-up period ranged from 12 to 50 months.CONCLUSION: Although the microscopic transoral approach has been considered the gold standard for craniovertebral junctionsurgical management, endoscopic approaches are feasible, safe, and effective for addressing pathologies in this region, withdeveloping technique and surgical experience.
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Bu Makaleye Atıf Yap
KAHİLOĞULLARI, G., EROGLU, U., YAKAR, F., BOZKURT, M., BETON, S., MEÇO, C., CAGLAR, Y. S. (2019). Endoscopic Endonasal Approaches to Craniovertebral Junction Pathologies: A Single-Center Experience. Turkish Neurosurgery, Cilt: 29 - Sayı: 4, 486–492. https://ajindex.com/articles/417799
Abuzayed B, Tanriover N, Gazioglu N, Akar Z: Extended endoscopic endonasal approach to the clival region. J Craniofac Surg 21: 245–251, 2010 2. Abuzayed B, Tanriover N, Gazioglu N, Ozlen F, Eraslan BS, Akar Z: Extended endoscopic endonasal approach to the anterior cranio-vertebral junction: Anatomic study. Turk Neurosurg 19: 249–255, 2009 3. Alfieri A, Jho HD, Tschabitscher M: Endoscopic endonasal approach to the ventral cranio-cervical junction: Anatomical study. Acta Neurochir (Wien) 144: 219–225, 2002 4. Ammirati M, Bernardo A: Analytical evaluation of complex anterior approaches to the cranial base: An anatomic study. Neurosurgery 43: 1398–1407, 1998 5. Baird CJ, Conway JE, Sciubba DM, Prevedello DM, QuinonesHinojosa A, Kassam AB: Radiographic and anatomic basis of endoscopic anterior craniocervical decompression: A comparison of endonasal, transoral and transcervical approaches. Neurosurgery 65 Suppl 6:158–164, 2009 6. Caglar S, Bozkurt M, Kahilogullari G, Ozdemir M: Management of a rare and dangerous infectious lesion: Hydatid cyst disease of the odontoid process. WScJ 3: 29–32, 2012 7. Chan AK, Benet A, Ohya J, Zhang X, Vogel TD, Flis DW, El-Sayed IH, Mummaneni PV: The endoscopic transoral approach to the craniovertebral junction: An anatomical study with a clinical example. Neurosurg Focus 40: E11, 2016 8. Choi D, Crockard HA: Evolution of transoral surgery: Three decades of change in patients, pathologies, and indications. Neurosurgery 73: 296–303, 2013 9. Choi D, Gleeson M: Surgery for chordomas of the craniocervical junction: Lessons learned. Skull Base 20:41–45, 2010 10. Choudhri O, Mindea SA, Feroze A, Soudry E, Chang SD, Nayak JV: Experience with intraoperative navigation and imaging during endoscopic transnasal spinal approaches to the foramen magnum and odontoid. Neurosurg Focus 36: E4, 2014 11. Crockard HA: The transoral approach to the base of the brain and upper cervical cord. Ann R Coll Surg Engl 67:321–325, 1985 12. Crockard HA: Transoral surgery: Some lessons learned. Br J Neurosurg 9: 283–293, 1995 13. Crockard HA, Pozo JL, Ransford AO, Stevens JM, Kendall BE, Essigman WK: Transoral decompression and posterior fusion for rheumatoid atlanto-axial subluxation. J Bone Joint Surg Br 68: 350–356, 1986 14. de Almeida JR, Zanation AM, Snyderman CH, Carrau RL, Prevedello DM, Gardner PA, Kassam AB: Defining the nasopalatine line: The limit for endonasal surgery of the spine. Laryngoscope 119: 239–244, 2009 15. Delgado TE, Garrido E, Harwic