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Related Concept Videos

Cranial Bones: Lateral View01:27

Cranial Bones: Lateral View

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The lateral view of the cranium is dominated by temporal, sphenoid, and ethmoid bones.
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...
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Lateral Molar Approach-Driven Transoral Endoscopic Procedure for Benign Infratemporal Fossa Tumor Resection
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Far lateral approach: Is condylar resection required?

Harun-Ur-Rashid Mohammad, Sudhindra Vooturi, Manas Panigrahi1

  • 1Department of Neurosurgery, Krishna Institute of Medical Sciences, Hyderabad, Telangana, India.

Neurology India
|May 6, 2016
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Summary

The far lateral approach (FLA) offers a versatile and effective surgical option for craniocervical junction (CCJ) tumors, enabling good tumor resection with low complication rates and high patient independence.

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Area of Science:

  • Neurosurgery
  • Surgical Oncology
  • Spine Surgery

Background:

  • Craniocervical junction (CCJ) tumors present unique surgical challenges.
  • The far lateral approach (FLA) and its modifications are utilized for tumor resection in this region.

Purpose of the Study:

  • To report the experience and outcomes of using the FLA for surgical resection of CCJ tumors.
  • To evaluate the efficacy and safety of FLA and its modifications in treating various CCJ lesions.

Main Methods:

  • Retrospective review of 36 patients with CCJ lesions undergoing surgical excision.
  • Tumor classification based on anatomical location relative to the CCJ.
  • Preference for FLA and modifications for anterior and laterally placed tumors.
  • Definition of postoperative complications and perioperative mortality.

Main Results:

  • Simpson's Scale Grade 2 resection achieved in 18/19 meningioma patients.
  • Overall transient complication rate of 22% (8 patients), with no cerebrospinal fluid fistulas.
  • Permanent morbidity rate of 5.6% and perioperative mortality of 2.8% (1 patient).
  • 96% of patients were independent for activities of daily living at a mean follow-up of 4.1 years.

Conclusions:

  • The FLA is a versatile approach for ventrolateral brainstem and upper cervical cord lesions.
  • It provides adequate exposure with minimal retraction, facilitating tumor excision.
  • Specific modifications like the transjugular process approach are effective for jugular foramen tumors.