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Endoscope-assisted contralateral transmaxillary approach to the clivus and the hypoglossal canal: Technical case report

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dc.contributor.authorPamias-Portalatin, Eva
dc.contributor.authorMahato, Deependra
dc.contributor.authorRincon-Torroella, Jordina
dc.contributor.authorVivas-Buitrago, Tito
dc.contributor.authorQuiñones-Hinojosa, Alfredo
dc.contributor.authorBoahene, Kofi O.
dc.contributor.researchgroupNeuro Cienciasspa
dc.date.accessioned2022-05-09T22:50:50Z
dc.date.available2022-05-09T22:50:50Z
dc.date.issued2019-05-05
dc.descriptionDigitalspa
dc.description.abstractClival lesions are still considered surgically complex due to their anatomical location. Critical structures, such as the internal carotid arteries (ICAs), cavernous sinuses, cranial nerves, and brainstem, may be encased within the lesion. Although advances in endoscopic endonasal approaches have provided new routes to these lesions, exposure and resection of clival tumors through the endonasal route remain a technical challenge. Here, the authors report a left-sided endoscopic transmaxillary approach to access the right aspect of the clivus and the hypoglossal canal.A 35-year-old woman presented with progressive right 6th cranial nerve palsy. MRI revealed a contrast-enhancing right petroclival chondrosarcoma that involved Meckel's cave and extended into the right hypoglossal canal. An endoscopic-contralateral-transmaxillary approach through a left sublabial incision was used to access the right petroclival region and right hypoglossal canal. A left maxillary osteoplastic flap was elevated to expose the left maxillary sinus. This was followed by a left medial maxillectomy, gaining access to the left posterior nasal cavity. The posterior third of the left inferior turbinate and nasal septum were removed to access the right side of the petroclival region. Near-total resection was achieved without any vascular or neurological complications. A thin shell of residual tumor was left behind due to involvement of vital structures, such as the ICA, and further treated with proton-beam radiotherapy.The endoscopic-contralateral-transmaxillary approach provides a direct surgical corridor and good lateral visualization of the skull base vasculature. This approach allows wide maneuverability around the ICA and hypoglossal canal, which, in this case, allowed maximal tumor resection with full preservation of neurological function.spa
dc.description.researchareaCiencias Médicas y de la Saludspa
dc.format.extent7 pspa
dc.format.mimetypeapplication/pdfspa
dc.identifier.doi10.3171/2018.1.JNS171972
dc.identifier.urihttps://repositorio.udes.edu.co/handle/001/6748
dc.language.isoengspa
dc.publisher.placeUSAspa
dc.relation.citationendpage1615spa
dc.relation.citationstartpage1609spa
dc.relation.citationvolume130spa
dc.relation.citesPamias-Portalatin E, Mahato D, Rincon-Torroella J, Vivas-Buitrago T, Quiñones-Hinojosa A, Boahene KO. Endoscope-assisted contralateral transmaxillary approach to the clivus and the hypoglossal canal: technical case report. J Neurosurg. 2018 Jun 1:1-7. doi: 10.3171/2018.1.JNS171972. Epub ahead of print. PMID: 29932381.
dc.relation.indexedScopusspa
dc.relation.ispartofjournalJournal of Neurosurgeryspa
dc.rights©AANS 2019, except where prohibited by US copyright lawspa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial 4.0 Internacional (CC BY-NC 4.0)spa
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/spa
dc.sourcehttps://thejns.org/view/journals/j-neurosurg/130/5/article-p1609.xml?tab_body=pdf-23713spa
dc.subject.proposalCN = cranial nerveeng
dc.subject.proposalICA = internal carotid arteryeng
dc.subject.proposalChondroscarcomaeng
dc.subject.proposalClivuseng
dc.subject.proposalContralateraleng
dc.subject.proposalEndoscopeeng
dc.subject.proposalHypoglossal canalspa
dc.subject.proposalPituitary surgeryeng
dc.subject.proposalSkull baseeng
dc.subject.proposalTransmaxillaryeng
dc.subject.proposalTumoreng
dc.titleEndoscope-assisted contralateral transmaxillary approach to the clivus and the hypoglossal canal: Technical case reportspa
dc.typeArtículo de revistaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_6501spa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/articlespa
dc.type.redcolhttp://purl.org/redcol/resource_type/ARTspa
dc.type.versioninfo:eu-repo/semantics/publishedVersionspa
dcterms.audienceTodas las Audienciasspa
dspace.entity.typePublication
oaire.accessrightshttp://purl.org/coar/access_right/c_abf2spa
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85spa
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