The Transoral-Transpharyngeal Approach To The Middle And Lower Part Of Clivus And The Lesions Of Great Occipital Foramen And Upper Spine: Endosconic Anatomic Study

Part oneThe Transoral-Transpharyngeal Approach to the Middle and Lower Part of Clivus: Endosconic Anatomic StudyObjective To study intracranial anatomy in endosconic transoral- transpharyngeal approach to the middle and lower part of clivus, and measure some anatomic datas ,in order to guide clinical surgical operation . Methods (1)Ten adult cadaveric specimens were studied with microscope and 0°, 30° hard endoscopes alternatively by imitating operations via transoral-transpharyngeal approach; (2)Sixty dry skulls were examined. Results The transoral-approach was performed with a clival opening of 20 by 30 mm. Such a limited clival and dural opening allowed the insertion of the endoscope and instruments, full visualization of the anterolateral brainstem and cisternal spaces around it. The path way of road mapping for this approach composed of these marks according to the surgical procedure is as follows: oral pharynx→preclival tissue→bony marks (anterior part of great occipital foramen→lower part of clivus→pharyngeal tubercle→middle part of...