title: Craniovertebral Junction Transanasal and Transoral Approaches: Reconstruct the Surgical Pathways with Soft or Hard Tissue Endocopic Lines? This Is the Question.
abstract: A variety of pathological conditions may affect the clivus and the craniovertebral junction (CVJ). These include congenital disorders, chronic inflammation, neoplasms, infections, and posttraumatic conditions that could all result in CVJ compression and myelopathy Endoscopic-assisted procedures have been further developed for CVJ decompression and they have now become conventional approaches. The aims of the present study were:(1) to compare "radiological" and "surgical" nasoaxial lines (NAxLs); (2) to introduce an analogous radiological line as a predictor of the superior extension of the transoral approach (palatine inferior dental arch line (PIA); (3) to compare the "radiological" nasopalatine line (NPL) with the "surgical" NPL (SNPL) and surgical PIA (SPIA); (4) to compare "our" SNPL with the NAxL; and (5) to find possible radiological reference points to predict, preoperatively, the maximal extent of superior dissection for the transoral approach (SPIA).
authors.affiliation: Insitute of Neurosurgery, Medical School, Catholic University of Rome, Rome, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Visocchi
authors.affiliation: Division of Neurosurgery, Department of Neurosciences, Policlinico "G. Rodolico" University Hospital, Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Barbagallo
authors.affiliation: Department of Public Health, Institute of Legal Medicine, Catholic University of Rome, Rome, Italy.
authors.forename: Vincenzo Lorenzo
authors.initials: VL
authors.lastname: Pascali
authors.affiliation: Insitute of Neurosurgery, Medical School, Catholic University of Rome, Rome, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Mattogno
authors.affiliation: Insitute of Neurosurgery, Medical School, Catholic University of Rome, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Signorelli
authors.affiliation: Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Neurosurgical Clinic, University of Palermo, Palermo, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Iacopino
authors.affiliation: Department of Biomedical Sciences, Neurosurgery, University of Messina, Messina, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Germano'
authors.affiliation: Insitute of Neurosurgery, Medical School, Catholic University of Rome, Rome, Italy. giularocca86@gmail.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Rocca
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001368:Axis, Cervical Vertebra / Q000000981:diagnostic imaging*; D002102:Cadaver; D001270:Cervical Atlas / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000000981:diagnostic imaging*; D009296:Nasal Cavity / Q000000981:diagnostic imaging*; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods; D044583:Neuroendoscopy / Q000379:methods; D009777:Occipital Bone / Q000000981:diagnostic imaging*; D011859:Radiography; D014057:Tomography, X-Ray Computed
keywords: Craniovertebral junction; Endoscopy; Transnasal approach; Transoral approach