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Full endoscopic endonasal expanded approach to the petroclival region: optimizing the carotid-clival window

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An Erratum to this article was published on 10 June 2014

Abstract

Background

The petroclival junction (PCJ) is a challenging skull base location from neurosurgical point of view, especially if the retrocarotid space has to be reached.

Method

In response to this challenge, this report provides a detailed full description of the endoscopic endonasal expanded approach (EEA) to the petroclival region and retrocarotid space. We present the technique step by step, introducing a critical concept about the optimization of the petroclival drilling, generating the carotid-clival window (CCW). The CCW is delimited by the paraclival segment of the internal carotid artery ICA anterolaterally, the petrous bone posterolaterally, the clival dura medially, the synchondrosis inferiorly, and the cavernous sinus superiorly; therefore, this approach exposes an important nuance to augment the previous approaches for PCJ and retrocarotid space.

Conclusion

This technique provides a good surgical window and carries minimal risk.

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References

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Conflicts of interest

None.

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Authors and Affiliations

  1. Neurosurgical Department. HUiP La Fe de Valencia, Blv Sur, Valencia, S/N, 46026, Spain

    Juan Antonio Simal-Julián

  2. Neurosurgical Department HUyP La Fe, Valencis, Spain

    Pablo Miranda-Lloret & Carlos Botella-Asunción

  3. SpainNeurosurgical Department. HUyP La Fe de Valencia, Valencia, Spain

    Armin Kassam

Authors
  1. Juan Antonio Simal-Julián
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  2. Pablo Miranda-Lloret
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  3. Carlos Botella-Asunción
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  4. Armin Kassam
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Corresponding author

Correspondence to Juan Antonio Simal-Julián.

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Video: EEA to the PCJ. (M4V 50626 kb)

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Simal-Julián, J.A., Miranda-Lloret, P., Botella-Asunción, C. et al. Full endoscopic endonasal expanded approach to the petroclival region: optimizing the carotid-clival window. Acta Neurochir 156, 1627–1629 (2014). https://doi.org/10.1007/s00701-014-2125-6

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  • DOI: https://doi.org/10.1007/s00701-014-2125-6

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