Daniele Marchioni1, Matteo Alicandri-Ciufelli2,3, Alessia Rubini2, Livio Presutti2. 1. Otolaryngology Department, University Hospital of Verona, Verona, Italy. 2. Otolaryngology Department, University Hospital of Modena, Modena, Italy. 3. Neurosurgery Department, New Civil Hospital Sant'Agostino-Estense, Baggiovara, Italy.
Abstract
OBJECTIVES/HYPOTHESIS: Surgical approaches to the lateral skull base, internal auditory canal (IAC), and petrous bone are widely known and have been extensively recorded. Despite the benign nature and limited dimensions of lesions located in this anatomical region, extirpative surgical approaches are often required to reach and remove the disease. The aim of present report was to describe our initial experiences with minimally invasive endoscopic approaches to the lateral skull base. STUDY DESIGN: Retrospective review of patients' charts and video recordings from surgery. METHODS: Twelve patients were included in the study. Three main corridors to the lateral skull base were identified: the transcanal suprageniculate corridor, the transcanal transpromontorial corridor, and the transcanal infracochlear corridor. Landmarks, tips, and pitfalls of the approaches have been reviewed and highlighted. RESULTS: These corridors provide a direct approach to pathology involving the fundus, IAC, cochlea, petrous apex and geniculate ganglion region, without any external incision. The pathology was successfully removed in most cases with no important postoperative complications and reasonable facial nerve outcomes. CONCLUSIONS: The transcanal endoscopic approaches to the lateral skull base proved to be successful for pathology removal involving the fundus, IAC, cochlea, petrous apex, and geniculate ganglion region. Future widespread application of this kind of approach in lateral skull base surgery will depend on the development of technology, and surgical and anatomical refinements. LEVEL OF EVIDENCE: 4.
OBJECTIVES/HYPOTHESIS: Surgical approaches to the lateral skull base, internal auditory canal (IAC), and petrous bone are widely known and have been extensively recorded. Despite the benign nature and limited dimensions of lesions located in this anatomical region, extirpative surgical approaches are often required to reach and remove the disease. The aim of present report was to describe our initial experiences with minimally invasive endoscopic approaches to the lateral skull base. STUDY DESIGN: Retrospective review of patients' charts and video recordings from surgery. METHODS: Twelve patients were included in the study. Three main corridors to the lateral skull base were identified: the transcanal suprageniculate corridor, the transcanal transpromontorial corridor, and the transcanal infracochlear corridor. Landmarks, tips, and pitfalls of the approaches have been reviewed and highlighted. RESULTS: These corridors provide a direct approach to pathology involving the fundus, IAC, cochlea, petrous apex and geniculate ganglion region, without any external incision. The pathology was successfully removed in most cases with no important postoperative complications and reasonable facial nerve outcomes. CONCLUSIONS: The transcanal endoscopic approaches to the lateral skull base proved to be successful for pathology removal involving the fundus, IAC, cochlea, petrous apex, and geniculate ganglion region. Future widespread application of this kind of approach in lateral skull base surgery will depend on the development of technology, and surgical and anatomical refinements. LEVEL OF EVIDENCE: 4.
Authors: M Alicandri-Ciufelli; D Marchioni; G Pavesi; F Canzano; A Feletti; L Presutti Journal: Acta Otorhinolaryngol Ital Date: 2018-04 Impact factor: 2.124
Authors: Christoph Rathgeb; Lukas Anschuetz; Daniel Schneider; Cilgia Dür; Marco Caversaccio; Stefan Weber; Tom Williamson Journal: Eur Arch Otorhinolaryngol Date: 2018-02-13 Impact factor: 2.503
Authors: L Presutti; M Bonali; D Marchioni; G Pavesi; A Feletti; L Anschuetz; M Alicandri-Ciufelli Journal: Acta Otorhinolaryngol Ital Date: 2017-06 Impact factor: 2.124