caa a22 4500 463179234 CHVBK 20180406164834.0 cr unu---uuuuu 170326e20070601xx s 000 0 eng 10.1007/s00381-007-0332-7 doi (NATIONALLICENCE)springer-10.1007/s00381-007-0332-7 The extended endoscopic endonasal approach to the clivus and cranio-vertebral junction: anatomical study [Elektronische Daten] [L. Cavallo, P. Cappabianca, A. Messina, F. Esposito, L. Stella, E. de Divitiis, M. Tschabitscher] Object: Lesions located in the retroclival area and at the level of the cranio-vertebral junction are typically approached through a variety of anterior, antero-lateral and postero-lateral skull-based approach, either alone or in combination. The aim of this anatomical study was to demonstrate the possibility of an endoscopic endonasal approach to the clivus and cranio-vertebral junction. Materials and methods: Five fresh cadaver heads injected with colored latex were used. A modified endonasal endoscopic approach was made through two nostrils in all cases. Endoscopic dissections were performed using rigid endoscopes, 4mm in diameter, 18cm in length, with 0° lenses. Results: Access to the clivus was possible using a lower trajectory when compared to that necessary for the sellar region. The sphenoid sinus is entered, and its inferior wall is completely removed, permitting the union of the sphenoidal and rhinopharyngeal parts of the clivus. The entire clivus can be removed, and the cranio-vertebral junction is opened, removing the anterior arch of atlas and the odontoid process. After the opening of the dura, the anterior surface of the pons and upper spinal cord with corresponding nerves and vasculature are visible. Conclusion: The endoscopic endonasal approach to the clivus and cranio-vertebral junction could be a valid alternative for surgical treatment of anterior lesions of these regions. Adequate endoscopic skill, lab training on cadavers and dedicated tools are required for clinical applications of the approach. Springer-Verlag, 2007 Endoscopy nationallicence Endonasal approach nationallicence Clivus nationallicence Cranio-vertebral junction nationallicence Cavallo L. Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, via S. Pansini 5, 80131, Naples, Italy aut Cappabianca P. Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, via S. Pansini 5, 80131, Naples, Italy aut Messina A. Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, via S. Pansini 5, 80131, Naples, Italy aut Esposito F. Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, via S. Pansini 5, 80131, Naples, Italy aut Stella L. Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, via S. Pansini 5, 80131, Naples, Italy aut de Divitiis E. Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, via S. Pansini 5, 80131, Naples, Italy aut Tschabitscher M. Microsurgical and Endoscopic Anatomy Study Group, Institute of Anatomy, University of Wien, Vienna, Austria aut Child's Nervous System Springer-Verlag 23/6(2007-06-01), 665-671 0256-7040 23:6<665 2007 23 381 https://doi.org/10.1007/s00381-007-0332-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-007-0332-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Cavallo L. Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, via S. Pansini 5, 80131, Naples, Italy aut NATIONALLICENCE 700 1- Cappabianca P. Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, via S. Pansini 5, 80131, Naples, Italy aut NATIONALLICENCE 700 1- Messina A. Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, via S. Pansini 5, 80131, Naples, Italy aut NATIONALLICENCE 700 1- Esposito F. Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, via S. Pansini 5, 80131, Naples, Italy aut NATIONALLICENCE 700 1- Stella L. Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, via S. Pansini 5, 80131, Naples, Italy aut NATIONALLICENCE 700 1- de Divitiis E. Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, via S. Pansini 5, 80131, Naples, Italy aut NATIONALLICENCE 700 1- Tschabitscher M. Microsurgical and Endoscopic Anatomy Study Group, Institute of Anatomy, University of Wien, Vienna, Austria aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/6(2007-06-01), 665-671 0256-7040 23:6<665 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer