Management of the vertebral artery at the craniocervical junction.
OBJECTIVE
To study the surgical anatomy of the vertebral artery at the craniocervical junction and its related structures defining reliable landmarks for its safe exposure.


METHODS
Ten sides of 5 fresh cadavers were dissected using the lateral approach to the craniocervical junction.


RESULTS
Experience gained in studying the anatomic details of the vertebral artery at the craniocervical junction in cadavers from its exit at the transverse foramen of the second cervical vertebra to the vertebrobasilar junction provided the initial background for us to use the lateral approaches to the skull base to safely manage 4 cases with pathology reaching the close vicinity of vertebral artery at the craniocervical junction.


CONCLUSIONS
Thorough knowledge of the anatomy of the vertebral artery is mandatory before attempting surgery at the craniocervical junction. There are reliable landmarks that, when followed, could facilitate safe exposure and identification of the artery.
Cokkeser
Yaşar
Y
Department of Otorhinolaryngology, Inonu University, Malatya, Turkey. ycokkeser@yahoo.com
Naguib
Maged B
MB
Kizilay
Ahmet
A
D000328:Adult; D000368:Aged; D002102:Cadaver; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D002574:Cervical Vertebrae / Q000033:anatomy & histology / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D009333:Neck / Q000033:anatomy & histology / Q000601:surgery; D037981:Neck Dissection / Q000379:methods; D009456:Neurofibromatosis 1 / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D012886:Skull / Q000033:anatomy & histology / Q000601:surgery; D014711:Vertebral Artery / Q000033:anatomy & histology* / Q000601:surgery