Microsurgical anatomy of the inferior clivus via a far lateral approach evaluated by virtual reality system
Qian Zenghui
Feng Xu
Tang Ke
Abstract：Objective To establish the three-dimensional anatomical model of the inferior clivus via the far lateral approach by virtual reality system,and compare the impact of different target points on microanatomy.Methods CT and MRI scannings were performed in 15 adult cadaver heads.Image data was inputted into virtual reality system to establish three-dimensional anatomical model of the posterior cranial fossa.Far lateral approaches exposing different target points of the inferior clivus were outlined by selecting osseous landmarks on the calvaria and skull base.The anterior border of the ipsilateral jugular tubercle was revealed as route a,the anterior border of the heterolateral jugular tubercle as route b,and the anterior border of the foramen magnum as route c.The different microsurgical anatomic exposures of the 3 routes were observed,measured and compared.Results The three surgical routes via the far lateral approach passed through the posterior edge of the occipital condyle,upper part of the foramen magnum,lateral side of the brainstem,ventral side of the cerebellum,inside of the jugular bulb,and inferior edge of the accessory nerve,and reached the targets.Comparisons of the volume of the route,cranial nerve and artery showed:route b ＞ route a ＞ route c.Comparisons of the volume of osseous structures showed:route a＞ route c＞ route b.All the results reached statistical significance (P ＜ 0.05).Conclusion Simulative surgical route is beneficial to quantitatively compare the impact of operative directions on the anatomic characteristics of the far lateral approach in exposing the inferior clivus.
Keywords：approachfar lateralcranial fassaposterioranatomyregionalvirtual reality
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 414-416 )