Analytical Evaluation of Complex Anterior Approachesto the Cranial Base: An Anatomic Study

Analytical Evaluation of Complex Anterior Approachesto the Cranial Base: An Anatomic Study AbstractOBJECTIVEThe purpose of the present study was to evaluate the anatomic areas of the cranial base exposed by different complex anterior approachesMETHODSUsing 20 embalmed cadaveric heads, we executed five different anterior approaches, i.e., Le Fort 1 approach with splitting or down-fracturing of the hard palate, extended maxillectomy, median mandibulotomy with glossotomy, and mandibular swing transcervical approach. Each approach was performed a minimum of three times. The areas of the intra- and extracranial cranial base exposed by each approach were analytically examined by using a numerical grading system to assess the exposure of major anatomic and neurovascular structures.RESULTSGood exposure of the midline compartment of the cranial base was provided by the median mandibulotomy with glossotomy and by the Le Fort 1 approach with splitting of the hard palate, whereas the mandibular swing transcervical and extended maxillectomy approaches provided good exposure of the lateral compartment of the cranial base.CONCLUSIONUse of the numerical grading system allowed quantification of the exposure afforded by each approach, with respect to the different compartments (midline and lateral) of the intra- and extracranial cranial base, highlighting the differences among the approaches examined. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Analytical Evaluation of Complex Anterior Approachesto the Cranial Base: An Anatomic Study

Analytical Evaluation of Complex Anterior Approachesto the Cranial Base: An Anatomic Study

ANATOMIC REPORT A n a l y t i c a l E v a l u a t i o n o f C o m p l e x A n t e r i o r A p p r o a c h e s t o t h e C r a n i a l B a s e : A n A n a t o m i c S t u d y Mario Ammirati, M.D., Antonio Bernardo, M.D. Department of Neurological Surgery, University of California, Irvine, California O B JE C T IV E : The purpose of the present study was to evaluate the anatom ic areas of the cranial base exposed by different complex anterior approaches. M E T H O D S: Using 20 embalmed cadaveric heads, we executed five different anterior approaches, i.e., Le Fort 1 approach with splitting or dow n-fracturing of the hard palate, extended m axillectom y, median mandibulotomy with glossotomy, and m andibular swing transcervical approach. Each approach was performed a minimum of three times. The areas of the intra- and extracranial cranial base exposed by each approach were analytically IE examined by using a numerical grading system to assess the exposure of major anatom ic and neurovascular structures. n r RESU LTS: Good exposure of the m idline compartment of the cranial base was provided by the median mandibu­ til j lotomy with glossotomy and by the Le Fort 1 approach with splitting of the hard palate, whereas the mandibular swing transcervical and extended m axillectom y approaches provided good exposure of the lateral compartment lie of the cranial base. tied tuft C O N C L U S IO N : Use of the numerical grading system allowed quantification of the exposure afforded by each • tixx approach, with respect to the different compartments (m idline and lateral) of the intra- and extracranial cranial base, highlighting the differences among the approaches examined. (Neurosurgery 4 3 :13 9 8 -1 4 0 8 , 1998) BTt* Key words: Anterior approaches, C ra n ia l base, M icro su rgical anatom y, Sku ll base n the past few years, a large n u m b er of com p lex anterior pile M A TER IA LS A N D M E T H O D S ap p roaches to the extra- and intracranial cranial base...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199812000-00081
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVEThe purpose of the present study was to evaluate the anatomic areas of the cranial base exposed by different complex anterior approachesMETHODSUsing 20 embalmed cadaveric heads, we executed five different anterior approaches, i.e., Le Fort 1 approach with splitting or down-fracturing of the hard palate, extended maxillectomy, median mandibulotomy with glossotomy, and mandibular swing transcervical approach. Each approach was performed a minimum of three times. The areas of the intra- and extracranial cranial base exposed by each approach were analytically examined by using a numerical grading system to assess the exposure of major anatomic and neurovascular structures.RESULTSGood exposure of the midline compartment of the cranial base was provided by the median mandibulotomy with glossotomy and by the Le Fort 1 approach with splitting of the hard palate, whereas the mandibular swing transcervical and extended maxillectomy approaches provided good exposure of the lateral compartment of the cranial base.CONCLUSIONUse of the numerical grading system allowed quantification of the exposure afforded by each approach, with respect to the different compartments (midline and lateral) of the intra- and extracranial cranial base, highlighting the differences among the approaches examined.

Journal

NeurosurgeryOxford University Press

Published: Dec 1, 1998

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