Simple and safe resection of the crista galli

• Published in: Head & neck Vol. 46; no. 2; pp. 439 - 446
• Main Authors: Omura, Kazuhiro, Nomura, Kazuhiro, Aoki, Satoshi, Takeda, Teppei, Ebihara, Teru, Kimple, Adam J., Thorp, Brian D., Zeatoun, Abdullah L., Otori, Nobuyoshi, Senior, Brent A.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.02.2024; Wiley Subscription Services, Inc
• Subjects: anterior skull base; Cadaver; Cadavers; Cecum; endoscope; esthesioneuroblastoma; Esthesioneuroblastoma, Olfactory; Ethmoid Bone; Humans; margin; Nasal Cavity - surgery; Nose Neoplasms; olfactory neuroblastoma; Tumors; margin; olfactory neuroblastoma; anterior skull base; endoscope; esthesioneuroblastoma
• ISSN: 1043-3074; 1097-0347; 1097-0347
• DOI: 10.1002/hed.27590

A critical procedure in the transcribriform approach is the resection of the crista galli. However, the standard technique for crista galli resection has several disadvantages. We reviewed the cases of patients with olfactory neuroblastomas who underwent an endoscopic endonasal transcribriform approach using a newly developed technique for crista galli resection. We performed a cadaveric study to measure the superior accessibility limits using the proposed method. We included 38 patients with olfactory neuroblastomas in this study. The tumor invaded the posterior crista galli in four patients. The anterior end of the crista galli was not invaded by the tumor. Our cadaveric study showed that the dura was approachable to the point that was 7.4 ± 1.3 mm superior and 23.2 ± 7.2 mm lateral to the foramen cecum following crista galli removal. By resecting the crista galli in advance, manipulation of the superior dura became feasible.