Anatomical features of skull base and oral cavity : a pilot study to determine the accessibility of the sella by transoral robotic-assisted surgery
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2015
- handle: 10670/1.bp1xy1
- halshs: halshs-01457263
- doi: 10.1007/s10143-015-0635-1
Ce document est lié à :
info:eu-repo/semantics/altIdentifier/doi/10.1007/s10143-015-0635-1
Mots-clés
Anatomy Robotic surgery Sella turcica Skull base Transoral approach Transsphenoidal surgerySujets proches
Basicranium Base of skull Cranial baseCiter ce document
Aymeric Amelot et al., « Anatomical features of skull base and oral cavity : a pilot study to determine the accessibility of the sella by transoral robotic-assisted surgery », HAL-SHS : linguistique, ID : 10.1007/s10143-015-0635-1
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Résumé
The role of transoral robotic surgery (TORS) in the skull base emerges and represents the natural progression toward miniinvasive resections in confined spaces. The accessibility of the sella via TORS has been recently described on fresh human cadavers. An anatomic study is mandatory to know if this approach would be feasible in the majority of patients regardless of their oral morphological features. From 30 skull base CT scans from patients who were asked to open their mouth as wide as they can, we measured specific dimensions of the oral cavity and the skull base, such as length of the palate, mouth opening and distance from the sella to the palate. All data were acquired on a sagittal midline plane and on a 25° rotation plane, which simulated the axis of the robotic instruments. Looking at the projection of the dental palatine line on the sella, we studied possible predictive factors of sellar accessibility and tried to bring objective data for surgical feasibility. We also proposed an angle α to study the working angle at the skull base. We observed that the maximal mouth opening was a good predictive factor of sellar accessibility by TORS (p