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首页> 外文期刊>Neurosurgical focus >The rhinopalatine line as a reliable predictor of the inferior extent of endonasal odontoidectomies
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The rhinopalatine line as a reliable predictor of the inferior extent of endonasal odontoidectomies

机译：鼻ala线可作为预测鼻内齿状突切除术程度的可靠指标

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OBJECT The endoscopic endonasal approach (EEA) provides a minimally invasive corridor through which the cervicomedullary junction can be decompressed with reduced morbidity rates compared to those with the classic transoral approaches. The limit of the EEA is its inferior extent, and preoperative estimation of its reach is vital for determining its suitability. The aim of this study was to evaluate the actual inferior limit of the EEA in a surgical series of patients and develop an accurate and reliable predictor that can be used in planning endonasal odontoidectomies. METHODS The actual inferior extent of surgery was determined in a series of 6 patients with adequate preoperative and postoperative imaging who underwent endoscopie endonasal odontoidectomy. The medians of the differences between several previously described predictive lines, namely the nasopalatine line (NPL) and nasoaxial line (NAxL), were compared with the actual surgical limit and the hard-palate line by using nonparametric statistics. A novel line, called the rhinopalatine line (RPL), was established and corresponded best with the actual limit of the surgery. RESULTS There were 4 adult and 2 pediatric patients included in this study. The NPL overestimated the inferior extent of the surgery by an average (± SD) of 21.9 ± 8.1 mm (range 14.7-32.5 mm). The NAxL and RPL overestimated the inferior limit of surgery by averages of 6.9 ± 3.8 mm (range 3.7-13.3 mm) and 1.7 ± 3.7 mm (range ?2.8 to 8.3 mm), respectively. The medians of the differences between the NPL and NAxL and the actual surgery were statistically different (both p = 0.0313). In contrast, there was no statistically significant difference between the RPL and the inferior limit of surgery (p = 0.4375). CONCLUSIONS The RPL predicted the inferior limit of the EEA to the craniovertebral junction more accurately than previously described lines. The use of the RPL may help surgeons in choosing suitable candidates for the EEA and in selecting those for whom surgery through the oropharynx or the facial bones is the better approach.
机译：目的内窥镜鼻腔入路（EEA）提供了一种微创通道，与传统的经口入路相比，通过该通道可以减压并降低发病率。 EEA的局限性是其劣势，术前评估其范围对于确定其适用性至关重要。本研究的目的是评估一系列外科手术患者中EEA的实际下限，并开发出可用于计划鼻内齿状突切除术的准确可靠的预测因子。方法对6例接受了内镜下鼻腔齿状突切除术的患者进行了充分的术前和术后影像学检查，确定了实际的手术效果。通过使用非参数统计，将几个先前描述的预测线（即鼻op线（NPL）和鼻轴线（NAxL））之间的差异中值与实际手术极限和硬pal线进行了比较。建立了一条新的线，称为鼻ala线（RPL），它与手术的实际极限最匹配。结果本研究包括4名成人和2名儿科患者。 NPL高估了手术的劣势，平均水平为21.9±8.1毫米（±14.7-32.5毫米）（±SD）。 NAxL和RPL分别高估了手术的下限，平均分别为6.9±3.8毫米（3.7-13.3毫米）和1.7±3.7毫米（2.8至8.3毫米）。 NPL和NAxL与实际手术之间差异的中位数在统计学上不同（均为p = 0.0313）。相反，RPL与手术下限之间无统计学差异（p = 0.4375）。结论RPL预测的EEA的下限比颅骨交界处更准确。 RPL的使用可以帮助外科医生选择合适的EEA候选者，以及选择通过口咽或面部骨骼进行手术的更好方法。

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