caa a22 4500 445831804 CHVBK 20180317145317.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1007/s00586-011-1769-7 doi (NATIONALLICENCE)springer-10.1007/s00586-011-1769-7 Endoscope-assisted microsurgical transoral approach to the anterior craniovertebral junction compressive pathologies [Elektronische Daten] [Massimiliano Visocchi, Francesco Doglietto, Giuseppe Della Pepa, Giuseppe Esposito, Giuseppe La Rocca, Concezio Di Rocco, Giulio Maira, Eduardo Fernandez] At the present time, an update to the classical microsurgical transoral decompression is strongly provided by the most recent literature dealing with the introduction of the endoscopy in spine surgery. In this paper, we present our experience on the endoscope-assisted microsurgical transoral approach to anterior craniovertebral junction (CVJ) compressive pathology. We analysed seven patients (3 paediatrics and 4 adults ranging from 6 to 78years) operated on for CVJ decompressive procedures using an open access, microsurgical technique, neuronavigation and endoscopy. All techniques mentioned were simultaneously employed. Among the endoscopic routes described in the literature, we have preferred the transoral using 30° endoscopes. In all the cases endoscopy allowed a radical decompression compared to the microsurgical technique alone, as confirmed intraoperatively with contrast medium fluoroscopy. In conclusion, endoscopy represents a useful complement to the standard microsurgical approach to the anterior CVJ; it provides information for a better decompression with no need for soft palate splitting, hard palate resection, or extended maxillotomy. Moreover, intraoperative fluoroscopy helps to recognize residual compression. Virtually, in normal anatomic conditions, no surgical limitations exist for endoscopically assisted transoral approach, compared with the pure endonasal and transcervical endoscopic approaches. In our opinion, the endoscope deserves a role as "support” to the standard transoral microsurgical approach since 30° angulated endoscopy significantly increases the surgical area exposed at the level of the anterior CVJ. Springer-Verlag, 2011 Transoral nationallicence Craniovertebral junction nationallicence Endoscope-assisted nationallicence Microsurgical nationallicence Visocchi Massimiliano Istituto di Neurochirurgia, Catholic University School of Medicine, Policlinico "A. Gemelli”, Largo A. Gemelli, 8, 00168, Rome, Italy aut Doglietto Francesco Istituto di Neurochirurgia, Catholic University School of Medicine, Policlinico "A. Gemelli”, Largo A. Gemelli, 8, 00168, Rome, Italy aut Della Pepa Giuseppe Istituto di Neurochirurgia, Catholic University School of Medicine, Policlinico "A. Gemelli”, Largo A. Gemelli, 8, 00168, Rome, Italy aut Esposito Giuseppe Istituto di Neurochirurgia, Catholic University School of Medicine, Policlinico "A. Gemelli”, Largo A. Gemelli, 8, 00168, Rome, Italy aut La Rocca Giuseppe Istituto di Neurochirurgia, Catholic University School of Medicine, Policlinico "A. Gemelli”, Largo A. Gemelli, 8, 00168, Rome, Italy aut Di Rocco Concezio Istituto di Neurochirurgia, Catholic University School of Medicine, Policlinico "A. Gemelli”, Largo A. Gemelli, 8, 00168, Rome, Italy aut Maira Giulio Istituto di Neurochirurgia, Catholic University School of Medicine, Policlinico "A. Gemelli”, Largo A. Gemelli, 8, 00168, Rome, Italy aut Fernandez Eduardo Istituto di Neurochirurgia, Catholic University School of Medicine, Policlinico "A. Gemelli”, Largo A. Gemelli, 8, 00168, Rome, Italy aut European Spine Journal Springer-Verlag 20/9(2011-09-01), 1518-1525 0940-6719 20:9<1518 2011 20 586 https://doi.org/10.1007/s00586-011-1769-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1769-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Visocchi Massimiliano Istituto di Neurochirurgia, Catholic University School of Medicine, Policlinico "A. Gemelli”, Largo A. Gemelli, 8, 00168, Rome, Italy aut NATIONALLICENCE 700 1- Doglietto Francesco Istituto di Neurochirurgia, Catholic University School of Medicine, Policlinico "A. Gemelli”, Largo A. Gemelli, 8, 00168, Rome, Italy aut NATIONALLICENCE 700 1- Della Pepa Giuseppe Istituto di Neurochirurgia, Catholic University School of Medicine, Policlinico "A. Gemelli”, Largo A. Gemelli, 8, 00168, Rome, Italy aut NATIONALLICENCE 700 1- Esposito Giuseppe Istituto di Neurochirurgia, Catholic University School of Medicine, Policlinico "A. Gemelli”, Largo A. Gemelli, 8, 00168, Rome, Italy aut NATIONALLICENCE 700 1- La Rocca Giuseppe Istituto di Neurochirurgia, Catholic University School of Medicine, Policlinico "A. Gemelli”, Largo A. Gemelli, 8, 00168, Rome, Italy aut NATIONALLICENCE 700 1- Di Rocco Concezio Istituto di Neurochirurgia, Catholic University School of Medicine, Policlinico "A. Gemelli”, Largo A. Gemelli, 8, 00168, Rome, Italy aut NATIONALLICENCE 700 1- Maira Giulio Istituto di Neurochirurgia, Catholic University School of Medicine, Policlinico "A. Gemelli”, Largo A. Gemelli, 8, 00168, Rome, Italy aut NATIONALLICENCE 700 1- Fernandez Eduardo Istituto di Neurochirurgia, Catholic University School of Medicine, Policlinico "A. Gemelli”, Largo A. Gemelli, 8, 00168, Rome, Italy aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/9(2011-09-01), 1518-1525 0940-6719 20:9<1518 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer