Surgical freedom of odontoidectomy via endoscopic endonasal approach

Ruichun LI; Chen Liang; Shiwen Guo; Cheng Yang; Minxue Lian; Qian Song; Baixiang HE; Xu Yang; Gang Bao

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Surgical freedom of odontoidectomy via endoscopic endonasal approach

VernacularTitle:内镜下经鼻扩大入路齿状突切除术的自由度分析
Author: Ruichun LI ¹ ; Chen LIANG ¹ ; Shiwen GUO ¹ ; Cheng YANG ² ; Minxue LIAN ¹ ; Qian SONG ¹ ; Baixiang HE ¹ ; Xu YANG ³ ; Gang BAO ¹
Author Information

1. Department of Neurosurgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061
2. Department of Surgery, Xi’an Central Hospital of Shaanxi Province, Xi’an 710048
3. Department of Neurosurgery, Pucheng County Hospital, Weinan City 715500, China
Publication Type:Journal Article
Keywords: odontoidectomy; endoscopy; transnasal approach; surgical freedom
From: Journal of Xi'an Jiaotong University(Medical Sciences) 2021;42(3):345-348
CountryChina
Language:Chinese
Abstract: 【Objective】 To quantitatively analyze the surgical freedom of odontioectomy via endoscopic endonasal approach. 【Methods】 Seven adult head specimens were dissected by the endoscopic transnasal approach to the sellar region and craniocervical junction. The center of sellar floor (CenSF), opticocarotid recess (LOCR), foramen magnum, atlas, atlas-occipital joint and tip of odontoid process (TOP) were exposed. The surgical freedom of TOP was calculated by using the spatial coordinate positioning system of neuronavigation, and compared with that of LOCR and CenSF. 【Results】 CenSF and LOCR were common landmarks in the endonasal endoscopic approach. When the surgical freedom between TOP and CenSF and LOCR was compared, it indicated that ① The angle of attack on axial plane (AAAP):There was a significant difference among TOP, LOCR and CenSF (5.7 ° vs. 6.9 ° vs. 8.5 °, P=0.004). The comparison between the two groups showed that TOP was less than CenSF (P=0.003). ② The angle of attack on sagittal plane (AASP): There was a significant difference among TOP, LOCR and CenSF (6.3° vs. 7.0° vs. 9.5°, P=0.009). The TOP was less than CenSF (P=0.008). ③ There was no statistical significance between TOP and LOCR in surgical freedom (P=0.604, P=0.688). 【Conclusion】 Endoscopic transnasal approach can provide sufficient surgical freedom for odontoidectomy.