Eugenio Cárdenas Ruiz-Valdepeñas1, Ariel Kaen2, Gustavo Pérez Prat3, Jesus Ambrosiani Fernandez4. 1. Department of Neurological Surgery, Hospital Virgen Del Rocío, Avenida Manuel Siurot s/n, 41013, Seville, Spain. eugeniocarde@hotmail.com. 2. Department of Neurological Surgery, Hospital Virgen Del Rocío, Avenida Manuel Siurot s/n, 41013, Seville, Spain. 3. Department of Neurological Surgery, Hospital Vall d'Hebron, Barcelona, Spain. 4. Faculty of Anatomy, University of Sevilla, Seville, Spain.
Abstract
BACKGROUND: Nowadays, endoscopic endonasal expanded approach targeting for the clival lower third is well described in literature. Nonetheless, great variations can be found among surgical groups, specially during the earlier stages of this procedure. METHOD: We present a step by step description of the clival lower third approach until entering the dural space, setting its bony limits. We describe the basipharyngeal flap tailoring as a helpful option for latter reconstruction. The study of cadaveric specimens adds clarifying dissections. CONCLUSIONS: The expansion in the coronal plane is providential in most of the intradural lesions of the inferior clivus. Basipharyngeal flap may help seal the surgical defects in this area.
BACKGROUND: Nowadays, endoscopic endonasal expanded approach targeting for the clival lower third is well described in literature. Nonetheless, great variations can be found among surgical groups, specially during the earlier stages of this procedure. METHOD: We present a step by step description of the clival lower third approach until entering the dural space, setting its bony limits. We describe the basipharyngeal flap tailoring as a helpful option for latter reconstruction. The study of cadaveric specimens adds clarifying dissections. CONCLUSIONS: The expansion in the coronal plane is providential in most of the intradural lesions of the inferior clivus. Basipharyngeal flap may help seal the surgical defects in this area.