JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY) ›› 2016, Vol. 30 ›› Issue (3): 47-51.doi: 10.6040/j.issn.1673-3770.0.2016.015

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Anatomical and clinical evaluation of the endoscopic transoral transpharyngeal approach to the atlantoaxial.

XIE Chang1, YAN Bin2, LI Jianxing3, LU Yongtian   

  1. 1. Department of Otolaryngology &Head and Neck Surgery, Shenzhen Second Peoples Hospital of Clinical College, Anhui Medical University, Shenzhen 518035, Guangdong, China;2. Department of Spine Surgery, Shenzhen Second Peoples Hospital Clinical College, Shenzhen 518035, Guangdong, China;3. Department of Otolaryngology &Head and Neck Surgery, Central Hospital of Longhua New District, Shenzhen 518110, Guangdong, China
  • Received:2016-01-16 Online:2016-06-16 Published:2016-06-16

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Abstract: Objective To evaluate the feasibility of endoscopic transoral transpharyngeal approach to the atlantoaxial. Methods Endoscopic transoral approach was performed in 5 cadaveric heads and necks. The atlantoaxial was measured with CT. Results (1) The range from clivus to C3 could be exposed by this approach, including atlas, axis, lateral mass, odontoid process and vertebral artery. (2) The anterior tubercle of the atlas could serve as a landmark leading to the endoscopic transoral atlantoaxis surgery. The arch could be drilled either from the tubercle to the lateral side or broken from the junction to the lateral mass. Endoscopic odontoid dissection should begin at the apex of the odontoid, and proceeded inferiorly. There was a “safe zone” in the front of atlantoaxis of transoral-transpharyngeal approach. (3) CT results showed: length of anterior arch of atlas 19.5±2.8 mm, the thickness of anterior tubercle of atlas 8.0±0.4 mm, atlas lateral horizontal diameter(left/right)12.7±2.3mm/12.7±1.6 mm, atlas lateral sagittal diameter(left/right)15.0±2.5 mm/15.3±1.4 mm, spacing of atlas transverse process the inside hole 47.2±1.6 mm, spacing of atlas lateral transverse process hole 60.4±1.4 mm, angle of odontoid 10.2±1.3°, spacing of axis transverse process the inside hole 29.2±1.7 mm, spacing of axis lateral transverse process hole 44.3±1.6 mm. Conclusion Endoscopic transoral transpharyngeal approach to the atlantoaxial is technically feasible, which provides a good exposure and the same decompressing size as conventional transoral-transpharyngeal approach. It is safe and minimal invasive, and can be widely applied in clinical practice.

Key words: Endoscopic technique, Axis, Anatomy, Atlas

CLC Number: 

  • R762.6
[1] Hsu W, Wolinsky J P, Gokaslan Z L, et al. Transoral approaches to the cervical spine[J]. Neurosurgery, 2010, 66(3):119-125.
[2] 黄选兆. 实用耳鼻咽喉头颈外科学[M]. 2版. 北京: 人民卫生出版社, 2008: 288-289.
[3] Doherty B J, Heggeness M H. The quantitative anatomy of the atlas[J]. Spine, 1994, 19(22):2497-500.
[4] 柏树令. 系统解剖学[M]. 8版. 北京: 人民卫生出版社, 2009: 17-46.
[5] 胥少汀. 实用骨科学[M]. 4版. 北京: 人民军医出版社, 2012: 1935-1969.
[6] Doherty B J, Heggeness M H. Quantitative anatomy of the second cervical vertebra[J]. Spine, 1976, 20(5):513-517.
[7] Li Shi, Chai Yu, Li Yikai, et al. Quantitative anatomy of the tubercle of lateral mass of atlas and dens of axis and its clinical significance[J]. Chin J Anat, 2014, 37(2):212-216.
[8] Fine A D, Cardoso A, Rhoton A L Jr. Microsurgical anatomy of the extracranial-extradural origin of the posterior inferior cerebellar artery[J]. J Neurosurg, 1999, 91(4):645-652.
[9] Wang Z, Xia H, Wu Z, et al. Detailed anatomy for the transoral approach to the craniovertebral junction: an exposure and safety study[J]. J Neurol Surg B Skull Base, 2014, 75(2):133-139.
[10] Wang Y, Yang M, Zhang H, et al. Exploring the Safety Range via the Transoral Approach to the Craniovertebral Junction[J]. J Craniofac Surg, 2014, 25(4):1473-1475.
[11] Urculo-Bareño E, Alfaro-Baca R, Astudillo-Alarcón E, et al. Transoral decompression of the brain stem in a basilar impression secondary to rheumatoid arthritis. Description of a case and survey of the literature[J]. Rev Neurol, 2003, 36(9):846-851.
[12] Tanriverdi O, Tugcu B, Gunaldi O, et al. The selective odontoidectomy: endoscopic endonasal approach to the craniocervical junction[J]. J Craniofac Surg, 2014, 25(4):1482-1487.
[13] Song K J, Lee K B, Kim K N, et al. Treatment of odontoid fractures with single anterior screw fixation[J]. J Clin Neurosci, 2007, 14(9):824-830.
[14] Ma W, Xu N, Hu Y, et al. Unstable atlas fracture treatment by anterior plate C1-ring osteosynthesis using a transoral approach[J]. Eur Spine J, 2013, 22(10):2232-2239.
[15] Ai F, Yin Q, Wang Z, et al. Applied anatomy of transoral atlantoaxial reduction plate internal fixation[J]. Spine, 2006, 31(2):128-132.
[16] Kandziora F, Schulze-Stahl N, Khodadadyan-Klostermann C, et al. Screw placement in transoral atlantoaxial plate systems: an anatomical study[J]. J Neurosurg, 2001, 95(1):80-87.
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