Document Detail

Endoscopic-assisted microsurgical techniques at the craniovertebral junction: 4 illustrative cases and literature review.
MedLine Citation:
PMID:  24793465     Owner:  NLM     Status:  Publisher    
BACKGROUND: Endoscopic-assisted microsurgery (EAM) techniques are employed to improve visualization of the surgical field while minimizing brain retraction and trauma to neurovascular structures. There have been several reports in the literature on the indications and advantages of endoscopic-assisted techniques when operating at the craniovertebral junction (CVJ). The purpose of this study was to present illustrative cases and to perform a literature review of endoscopic-assisted microsurgical techniques at the CVJ.
METHODS: A review of the literature was compiled through MEDLINE/OVID and using cross-references of articles on Pubmed. Illustrative cases from the senior author's clinical series are presented to highlight indications and the utility of EAM at the CVJ.
RESULTS: Our literature review supports the utility of the endoscope in the transoral, transcervical, lateral, far lateral and posterolateral approaches. In particular EAM can be used in the transoral approach to increase surgical exposure of the clivus and minimize the need to split the soft palate while in the far lateral and posterolateral approaches, EAM can improve visualization down narrow or deep surgical corridors to help identify critical neurovascular structures and minimize the need for extensive bony removal. In general, the endoscope can be used to look around bony, vascular, or neoplastic lesions to visualize the surgical space behind these structures as well as to assess for tumor remnants after microsurgical resection.
CONCLUSION: EAM techniques can improve illumination and visualization of the surgical field at the CVJ. In addition, the EAM techniques can help to minimize the need for brain retraction or extensive exposures. Utilization of both the endoscope and the microscope allows the surgeon to benefit from the advantages of each modality.
Silky Chotai; Varun R Kshettry; Mario Ammirati
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Publication Detail:
Type:  REVIEW     Date:  2014-3-13
Journal Detail:
Title:  Clinical neurology and neurosurgery     Volume:  121C     ISSN:  1872-6968     ISO Abbreviation:  Clin Neurol Neurosurg     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-5-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7502039     Medline TA:  Clin Neurol Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-9     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier B.V. All rights reserved.
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