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Ohnishi YI, Nakajima N, Fujiwara S, et al. A Sufficient Surgical Window for Deep-Seated Extracranial Schwannomas in the Craniocervical Junction by the Anterolateral Approach. Neurospine. 2019;17(2):453-460doi: 10.14245/ns.1938270.135.
Ohnishi, Y. I., Nakajima, N., Fujiwara, S., Moriwaki, T., Arita, H., & Kishima, H. (2020). A Sufficient Surgical Window for Deep-Seated Extracranial Schwannomas in the Craniocervical Junction by the Anterolateral Approach. Neurospine, 17(2), 453-460. https://doi.org/10.14245/ns.1938270.135
Ohnishi, Yu-Ichiro, et al. "A Sufficient Surgical Window for Deep-Seated Extracranial Schwannomas in the Craniocervical Junction by the Anterolateral Approach." Neurospine vol. 17,2 (2020): 453-460. doi: https://doi.org/10.14245/ns.1938270.135
Ohnishi YI, Nakajima N, Fujiwara S, Moriwaki T, Arita H, Kishima H. A Sufficient Surgical Window for Deep-Seated Extracranial Schwannomas in the Craniocervical Junction by the Anterolateral Approach. Neurospine. 2020 Jun;17(2):453-460. doi: 10.14245/ns.1938270.135. Epub 2019 Nov 04. PMID: 31694358; PMCID: PMC7338961.
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Neurospine. 2020 Jun;17(2):453-460. doi: 10.14245/ns.1938270.135. Epub 2019 Nov 04.

A Sufficient Surgical Window for Deep-Seated Extracranial Schwannomas in the Craniocervical Junction by the Anterolateral Approach.

Neurospine

Yu-Ichiro Ohnishi, Nobuhiko Nakajima, Sho Fujiwara, Takashi Moriwaki, Hideyuki Arita, Haruhiko Kishima

Affiliations

  1. Department of Neurosurgery, Osaka University Medical School, Osaka, Japan.

PMID: 31694358 PMCID: PMC7338961 DOI: 10.14245/ns.1938270.135

Abstract

Care should be taken regarding surrounding anatomic structures during access to deepseated extracranial schwannomas in the craniocervical junction (CCJ). Herein, we present surgical tips for extracranial schwannomas in the CCJ using the anterolateral approach. A retrospective review was performed of 3 cases of surgical treatment of extracranial schwannomas in the CCJ by the anterolateral approach, which is a presternomastoid retrojugular route to the CCJ. The combination of neck rotation and reflection of the sternocleidomastoid muscle presented a sufficient, shallow surgical field for the CCJ. We could identify tumors along the accessory nerves and internal jugular veins, and had sufficient rostrocaudal working space to resect the tumors. Two cases were enucleated total resection and 1 was subtotal resection. Two patients experienced transient postoperative vocal cord partial paralysis and 1 had transient dysphagia. These neurological complications improved within 1 month. The anterolateral approach can provide a shallow and sufficient rostral and caudal surgical window.

Keywords: Atlanto-Axial Joint; Atlanto-Occipital Joint; Schwannoma; Skull base

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