Transcondylar approachの基本と応用
Transcondylar approachは通常の後頭下開頭に加え, 側方の後頭顆窩と後頭顆後内側1/3の骨削除, さらに環椎の半側椎弓切除や頚静脈結節の削除を加えることにより, 延髄の圧排に椎骨脳底動脈の血管性病変や延髄前面, 側面, 斜台部の病変に到達するものである. VA-PICA動脈瘤, 大孔部の髄膜腫, endodermal cyst, 類上皮腫, さらには下位脳神経のMVDなどが対象となりうる. 血管内手術, 定位放射線手術等の技術が円熟しつつある現在, transcondylar approachは決して使用頻度は高くはないものの, 必要時には近傍の外科解剖を熟知したうえで確実...
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| Published in | 脳神経外科ジャーナル Vol. 21; no. 11; pp. 857 - 863 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本脳神経外科コングレス
2012
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0917-950X 2187-3100 |
| DOI | 10.7887/jcns.21.857 |
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| Abstract | Transcondylar approachは通常の後頭下開頭に加え, 側方の後頭顆窩と後頭顆後内側1/3の骨削除, さらに環椎の半側椎弓切除や頚静脈結節の削除を加えることにより, 延髄の圧排に椎骨脳底動脈の血管性病変や延髄前面, 側面, 斜台部の病変に到達するものである. VA-PICA動脈瘤, 大孔部の髄膜腫, endodermal cyst, 類上皮腫, さらには下位脳神経のMVDなどが対象となりうる. 血管内手術, 定位放射線手術等の技術が円熟しつつある現在, transcondylar approachは決して使用頻度は高くはないものの, 必要時には近傍の外科解剖を熟知したうえで確実に実践, 応用できるよう習得しておくべき重要なアプローチの1つである. |
|---|---|
| AbstractList | Transcondylar approachは通常の後頭下開頭に加え, 側方の後頭顆窩と後頭顆後内側1/3の骨削除, さらに環椎の半側椎弓切除や頚静脈結節の削除を加えることにより, 延髄の圧排に椎骨脳底動脈の血管性病変や延髄前面, 側面, 斜台部の病変に到達するものである. VA-PICA動脈瘤, 大孔部の髄膜腫, endodermal cyst, 類上皮腫, さらには下位脳神経のMVDなどが対象となりうる. 血管内手術, 定位放射線手術等の技術が円熟しつつある現在, transcondylar approachは決して使用頻度は高くはないものの, 必要時には近傍の外科解剖を熟知したうえで確実に実践, 応用できるよう習得しておくべき重要なアプローチの1つである. |
| Author | 長谷川, 光広 |
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| Copyright | 2012 日本脳神経外科コングレス |
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| References | 4) Gilsbach JM, Sure U, Mann W : The supracondylar approach to the jugular tubercle and hypoglossal canal. Surg Neurol 50 : 563-570, 1998. 9) Nanda A, Vincent DA, Vannemreddy PS, Baskaya MK, Chanda A : Far-lateral approach to intradural lesions of the foramen magnum without resection of the occipital condyle. J Neurosurg 96 : 302-309, 2002. 15) Yamamoto S, Sunada I, Matsuoka Y, Hakuba A, Nishimura S : Persistent primitive hypoglossal artery aneurysms--report of two cases. Neurol Med Chir (Tokyo) 31 : 199-202, 1991. 8) Morera VA, Fernandez-Miranda JC, Prevedello DM, Madhok R, Barges-Coll J, Gardner P, Carrau R, Snyderman CH, Rhoton AL Jr, Kassam AB : “Far-medial” expanded endonasal approach to the inferior third of the clivus : the transcondylar and transjugular tubercle approaches. Neurosurgery 66 (6 Suppl Operative) : 211-219 ; discussion 219-220, 2010. 5) Hasegawa M : Foramen magnum meningioma. in Kalangu K (ed) : Essentials of the practice of neurosurgery. Nagoya, Access Publishing Company, 2010, pp.187-193. 10) Rhoton AL Jr : The far-lateral approach and its transcondylar, supracondylar, and paracondylar extensions. Neurosurgery 47 (3 Suppl) : S195-209, 2000. 1) Anson JA, Spetzler RF : Endarterectomy of the intradural vertebral artery via the far lateral approach. Neurosurgery 33 : 804-810 ; discussion 810-811, 1993. 14) Velat GJ, Spetzler RF : The far-lateral approach and Its Variations. World Neurosurg Epub Nov 7, 1-2, 2011. 13) Spektor S, Anderson GJ, McMenomey SO, Horgan MA, Kellogg JX, Delashaw JB Jr : Quantitative description of the far-lateral transcondylar transtubercular approach to the foramen magnum and clivus. J Neurosurg 92 : 824-831, 2000. 11) Seeger W : Atlas of topographical anatomy of the brain and surrounding structures Wien, New York, Springer-Verlag, 1978. 12) Sen CN, Sekhar LN : An extreme lateral approach to intradural lesions of the cervical spine and foramen magnum. Neurosurgery 27 : 197-204, 1990. 3) George B, Dematons C, Cophignon J : Lateral approach to the anterior portion of the foramen magnum. Application to surgical removal of 14 benign tumors : technical note. Surg Neurol 29 : 484-490, 1988. 7) Matsushima T, Natori Y, Katsuta T, Ikezaki K, Fukui M, Rhoton AL : Microsurgical anatomy for lateral approaches to the foramen magnum with special reference to transcondylar fossa (supracondylar transjugular tubercle) approach. Skull Base Surg 8 : 119-125, 1998. 2) Bertalanffy H, Seeger W : The dorsolateral, suboccipital, transcondylar approach to the lower clivus and anterior portion of the craniocervical junction. Neurosurgery 29 : 815-821, 1991. 6) Heros RC : Lateral suboccipital approach for vertebral and vertebrobasilar artery lesions. J Neurosurg 64 : 559-562, 1986. |
| References_xml | – reference: 11) Seeger W : Atlas of topographical anatomy of the brain and surrounding structures Wien, New York, Springer-Verlag, 1978. – reference: 14) Velat GJ, Spetzler RF : The far-lateral approach and Its Variations. World Neurosurg Epub Nov 7, 1-2, 2011. – reference: 13) Spektor S, Anderson GJ, McMenomey SO, Horgan MA, Kellogg JX, Delashaw JB Jr : Quantitative description of the far-lateral transcondylar transtubercular approach to the foramen magnum and clivus. J Neurosurg 92 : 824-831, 2000. – reference: 4) Gilsbach JM, Sure U, Mann W : The supracondylar approach to the jugular tubercle and hypoglossal canal. Surg Neurol 50 : 563-570, 1998. – reference: 7) Matsushima T, Natori Y, Katsuta T, Ikezaki K, Fukui M, Rhoton AL : Microsurgical anatomy for lateral approaches to the foramen magnum with special reference to transcondylar fossa (supracondylar transjugular tubercle) approach. Skull Base Surg 8 : 119-125, 1998. – reference: 10) Rhoton AL Jr : The far-lateral approach and its transcondylar, supracondylar, and paracondylar extensions. Neurosurgery 47 (3 Suppl) : S195-209, 2000. – reference: 9) Nanda A, Vincent DA, Vannemreddy PS, Baskaya MK, Chanda A : Far-lateral approach to intradural lesions of the foramen magnum without resection of the occipital condyle. J Neurosurg 96 : 302-309, 2002. – reference: 5) Hasegawa M : Foramen magnum meningioma. in Kalangu K (ed) : Essentials of the practice of neurosurgery. Nagoya, Access Publishing Company, 2010, pp.187-193. – reference: 2) Bertalanffy H, Seeger W : The dorsolateral, suboccipital, transcondylar approach to the lower clivus and anterior portion of the craniocervical junction. Neurosurgery 29 : 815-821, 1991. – reference: 3) George B, Dematons C, Cophignon J : Lateral approach to the anterior portion of the foramen magnum. Application to surgical removal of 14 benign tumors : technical note. Surg Neurol 29 : 484-490, 1988. – reference: 8) Morera VA, Fernandez-Miranda JC, Prevedello DM, Madhok R, Barges-Coll J, Gardner P, Carrau R, Snyderman CH, Rhoton AL Jr, Kassam AB : “Far-medial” expanded endonasal approach to the inferior third of the clivus : the transcondylar and transjugular tubercle approaches. Neurosurgery 66 (6 Suppl Operative) : 211-219 ; discussion 219-220, 2010. – reference: 12) Sen CN, Sekhar LN : An extreme lateral approach to intradural lesions of the cervical spine and foramen magnum. Neurosurgery 27 : 197-204, 1990. – reference: 1) Anson JA, Spetzler RF : Endarterectomy of the intradural vertebral artery via the far lateral approach. Neurosurgery 33 : 804-810 ; discussion 810-811, 1993. – reference: 6) Heros RC : Lateral suboccipital approach for vertebral and vertebrobasilar artery lesions. J Neurosurg 64 : 559-562, 1986. – reference: 15) Yamamoto S, Sunada I, Matsuoka Y, Hakuba A, Nishimura S : Persistent primitive hypoglossal artery aneurysms--report of two cases. Neurol Med Chir (Tokyo) 31 : 199-202, 1991. |
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| Snippet | Transcondylar approachは通常の後頭下開頭に加え, 側方の後頭顆窩と後頭顆後内側1/3の骨削除, さらに環椎の半側椎弓切除や頚静脈結節の削除を加えることにより, 延髄の圧排に椎骨脳底動脈の血管性病変や延髄前面, 側面, 斜台部の病変に到達するものである. VA-PICA動脈瘤, 大孔部の髄膜腫,... |
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| SubjectTerms | condyle far-lateral foramen magnum skull base surgery transcondylar approach |
| Title | Transcondylar approachの基本と応用 |
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