title: A New Window for the Treatment of Posterior Cerebral Artery, Superior Cerebellar Artery, and Basilar Apex Aneurysm: The Expanded Endoscopic Endonasal Approach.
abstract: OBJECTIVE
  To explore the feasibility of an endoscopic endonasal transclival approach to treat aneurysms arising in the basilar apex, posterior cerebral arteries, and superior cerebellar arteries.
  
  
  METHODS
  Cadaveric anatomical study.
  
  
  METHODS
  Fifteen cadaveric specimens.
  
  
  METHODS
  Degree of surgical exposure of each artery attained, distance from the nasal vestibule to these three arteries, and feasibility of clipping these vessels using standard vascular clip applicators.
  
  
  RESULTS
  Both posterior cerebral arteries were exposed, 0.67 cm (standard deviation [SD]: 0.2) on the right side and 0.59 cm (SD: 0.2) on the left side. Both right and left superior cerebral arteries were exposed, 0.6 cm (SD: 0.2) and 0.7 cm (SD: 0.3), respectively. The length of the basilar artery exposed was 2.6 cm (SD: 0.3). The distance from the nasal vestibule to the posterior cerebral artery, superior cerebellar artery, and basilar apex was 10 cm with an SD of ± 0.7, 0.6, and 0.8 cm, respectively. We were able to apply clips on each of these three vessels with a minimal alteration of surrounding normal tissue.
  
  
  CONCLUSIONS
  The endoscopic endonasal transclival approach represents a potentially feasible surgical corridor to treat aneurysms arising from these vessels.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Lemos-Rodríguez
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States.
authors.forename: Satyan
authors.initials: S
authors.lastname: Sreenath
authors.affiliation: Department of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States.
authors.forename: Ajay
authors.initials: A
authors.lastname: Unnithan
authors.affiliation: Department of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States.
authors.forename: Vivian
authors.initials: V
authors.lastname: Doan
authors.affiliation: Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio, United States.
authors.forename: Pablo F
authors.initials: PF
authors.lastname: Recinos
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States; Department of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States.
authors.forename: Adam
authors.initials: A
authors.lastname: Zanation
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States; Department of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States.
authors.forename: Deanna
authors.initials: D
authors.lastname: Sasaki-Adams
keywords: basilar apex aneurysm; clipping aneurysms; endoscopic endonasal approach; posterior cerebral artery aneurysms; superior cerebellar aneurysm