Transoral Versus Transnasal Approach for Craniovertebral Junction Pathologies: Never Say Never

Massimiliano Visocchi, Gaetano Paludetti, Alessandro Olivi, Francesco Signorelli, Mario Rigante, Chenlong Liao, Giuseppe Barbagallo

Risultato della ricerca: Contributo in rivistaArticolo in rivista

9 Citazioni (Scopus)

Abstract

Objective For many years, the microsurgical transoral approach (TOA) has been accepted as the “gold standard” for the surgical treatment of a variety of congenital, developmental, and acquired pathologies affecting the craniovertebral junction. In the present study, we try to investigate both experimental and clinical fronts of such a challenging surgery, starting from the updated literature experience. TOA is actually presented as an “old-fashioned” surgical technique dealing with possible bacterial contamination, the need of postoperative nose gastric tube feeding for a week, the possible nasopharyngeal incompetence, and the postoperative tongue swelling. Otherwise, the endoscopic endonasal approach (EEA) appears strongly supported by the modern literature as the true “minimally invasive” procedure. Methods Our clinical experience deals with 23 anterior procedures in paediatric and adult patients (17 TOA and 6 EEA). We further report on our experimental cadaver laboratory study of 12 subjects. Results All the patients of TOA group but one were discharged after posterior procedures within two weeks and improved or remained unchanged after surgery and during the follow-up. No mayor complications occurred in TOA group. In EEA group two patients died for cerebrospinal fluid infection, for disease progression and for heart attack. Conclusion Our and other available data suggest that no clear superiority of EEA over endoscopic TOA can be assessed so far; on the other hand, EEA can produce complications similar to TOA in craniovertebral junction surgery.
Lingua originaleEnglish
pagine (da-a)592-603
Numero di pagine12
RivistaWorld Neurosurgery
Volume110
DOI
Stato di pubblicazionePubblicato - 2018

Keywords

  • CVJ pathologies
  • Endoscopy
  • Neurology (clinical)
  • Surgery
  • Transoral approach

Fingerprint Entra nei temi di ricerca di 'Transoral Versus Transnasal Approach for Craniovertebral Junction Pathologies: Never Say Never'. Insieme formano una fingerprint unica.

Cita questo