Quantitative Anatomic Comparison of Endoscopic Transnasal and Microsurgical Transcranial Approaches to the Anterior Cranial Fossa

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Agosti, Edoardo (author)

Quantitative Anatomic Comparison of Endoscopic Transnasal and Microsurgical Transcranial Approaches to the Anterior Cranial Fossa

Article/chapterEnglish2022

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2022-07-06
Congress of Neurological Surgeons,2022
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LIBRIS-ID:oai:DiVA.org:uu-486956
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-486956URI
https://doi.org/10.1227/ons.0000000000000312DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:150703274URI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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BACKGROUND: Several microsurgical transcranial approaches (MTAs) and endoscopic transnasal approaches (EEAs) to the anterior cranial fossa (ACF) have been described.OBJECTIVE: To provide a preclinical, quantitative, anatomic, comparative analysis of surgical approaches to the ACF.METHODS: Five alcohol-fixed specimens underwent high-resolution computed tomography. The following approaches were performed on each specimen: EEAs (transcribriform, transtuberculum, and transplanum), anterior MTAs (transfrontal sinus interhemispheric, frontobasal interhemispheric, and subfrontal with unilateral and bilateral frontal craniotomy), and anterolateral MTAs (supraorbital, minipterional, pterional, and frontotemporal orbitozygomatic approach). An optic neuronavigation system and dedicated software (ApproachViewer, part of GTx-Eyes II—UHN) were used to quantify the working volume of each approach and extrapolate the exposure of different ACF regions. Mixed linear models with random intercepts were used for statistical analyses.RESULTS: EEAs offer a large and direct route to the midline region of ACF, whose most anterior structures (ie, crista galli, cribriform plate, and ethmoidal roof) are also well exposed by anterior MTAs, whereas deeper ones (ie, planum sphenoidale and tuberculum sellae) are also well exposed by anterolateral MTAs. The orbital roof region is exposed by both anterolateral and lateral MTAs. The posterolateral region (ie, sphenoid wing and optic canal) is well exposed by anterolateral MTAs.CONCLUSION: Anterior and anterolateral MTAs play a pivotal role in the exposure of most anterior and posterolateral ACF regions, respectively, whereas midline regions are well exposed by EEAs. Furthermore, certain anterolateral approaches may be most useful when involvement of the optic canal and nerves involvement are suspected.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Neurologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Neurology hsv//eng
TEKNIK OCH TEKNOLOGIER Medicinteknik Medicinsk bildbehandling hsv//swe
ENGINEERING AND TECHNOLOGY Medical Engineering Medical Image Processing hsv//eng
NATURVETENSKAP Data- och informationsvetenskap Bioinformatik hsv//swe
NATURAL SCIENCES Computer and Information Sciences Bioinformatics hsv//eng
Anterior cranial fossa
Endoscopy
Microsurgery
Comparative study
Quantitative study
Skull base surgery
Approaches
Quantitative comparison
Endoscopic transnasal
Microsurgical transcranial
Neuronavigation
Evidence-based

Added entries (persons, corporate bodies, meetings, titles ...)

Saraceno, Giorgio (author)
Rampinelli, Vittorio (author)
Raffetti, ElenaKarolinska Institutet,Uppsala universitet,Luft-, vatten- och landskapslära,Department of Global Public Health Sciences, Karolinska Institute, Stockholm, Sweden,Center for Natural Hazards and Disaster Science(Swepub:uu)elera574 (author)
Veiceschi, Pierlorenzo (author)
Buffoli, Barbara (author)
Rezzani, Rita (author)
Giorgianni, Andrea (author)
Hirtler, Lena (author)
Alexander, Alex Yohan (author)
Deganello, Alberto (author)
Piazza, Cesare (author)
Nicolai, Piero (author)
Castelnuovo, Paolo (author)
Locatelli, Davide (author)
Peris-Celda, Maria (author)
Fontanella, Marco Maria (author)
Doglietto, Francesco (author)
Uppsala universitetLuft-, vatten- och landskapslära (creator_code:org_t)

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In:Operative Neurosurgery: Congress of Neurological Surgeons23:4, s. e256-e2662332-42522332-4260

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Neurology

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