Extreme lateral transodontoid approach to the ventral craniocervical junction: cadaveric dissection and case illustrations

Journal of Neurosurgery
Gmaan AlzhraniWilliam T Couldwell

Abstract

Surgical treatment of pathological processes involving the ventral craniocervical junction (CCJ) traditionally involves anterior and posterolateral skull base approaches. In cases of bilateral extension, when lesions extend beyond the midline to the contralateral side, a unilateral corridor may result in suboptimal resection. In these cases, the lateral extent of the tumor will prevent extirpation of the lesion via anterior surgical approaches. The authors describe a unilateral operative corridor developed along an extreme lateral trajectory to the anterior aspect of the clival and upper cervical dura, allowing exposure and resection of tumor on the contralateral side. This approach is used when the disease involves the bone structures inherent to stability at the anterior CCJ. To achieve exposure of the ventral CCJ, an extreme lateral transcondylar transodontoid (ELTO) approach was performed with transposition of the ipsilateral vertebral artery, followed by drilling of the C1 anterior arch. Resection of the odontoid process allowed access to the contralateral component of lesions across the midline to the region of the extracranial contralateral vertebral artery, maximizing resection. Exposure and details of the surgical proc...Continue Reading

References

Mar 1, 1989·Archives of Otolaryngology--head & Neck Surgery·R L Crumley, P H Gutin
Nov 1, 1987·American Journal of Surgery·E M KwasnikR W Vollman
Sep 1, 1972·Journal of Neurosurgery·W M Hammon, L G Kempe
Oct 1, 1980·Journal of Neurosurgery·A H MenezesD E McDonnell
Nov 15, 2000·Surgical Neurology·G K BejjaniC J Riedel
Mar 3, 2001·Cancer Causes & Control : CCC·M L McMasterD M Parry
Mar 2, 2006·Journal of Neurosurgery. Spine·Hyunchul ShinNoel I Perin
Jan 28, 2009·The Laryngoscope·John R de AlmeidaAmin B Kassam
Nov 26, 2009·Journal of Neurosurgery·Chandranath SenRaj K Shrivastava
Oct 15, 2013·The Laryngoscope·Kyle J ChambersStacey T Gray
May 24, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Pamela S JonesWilliam T Curry
Aug 12, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Akash J PatelAndrew Jea
Apr 2, 2015·Neurosurgical Focus·Alejandro J LopezNader S Dahdaleh

❮ Previous
Next ❯

Citations

Oct 12, 2019·Journal of Neurosurgery. Pediatrics·Jacob ArcherAndrew Jea

❮ Previous
Next ❯

Methods Mentioned

BETA
dissection
dissections
amputation
biopsy

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.