Abstract:

Objective　The aim of this study was to evaluate the feasibility of endoscope assisted far-lateral approach with neuronavigational guidance and to observe the anatomic structures of ventral craniocervical junction identified with the endoscope.　Methods　Six fresh cadaveric specimens were prepared for a far lateral approach to allow for microscopic, 0 degree endoscopic and 30 degrees endoscopic view. By drilling off the jugular tubercle and one-third of the occipital condyle with neuronavigation guidance, the increase in exposure and neurovascular structures visualization with the microscope were then evaluated. The exposure of the petroclivus area provided by the endoscope and by the operating microscope was measured and compared.　Results　Clear close-up views of the all neurovascular structures in deep ventral craniocervical junction and structures normally obstructed by the jugular tubercle and occipital condyle were obtained using the endoscope through three corridors enclosed with cranial nerves with neuronavigational guidance, as similar with far lateral transcondylar approach.　Conclusion　With the aid of the endoscope and neuronavigation guidance, the far lateral approach is a feasible procedure that allows the identification of all neurovascular structures in ventral craniocervical junction without drilling the jugular tubercle and occipital condyle and may be used to remove lesions involving in this area.

Key words: Neuronavigation, Neuroendoscope, Far lateral approach, Ventral craniocervical junction