{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T05:02:51Z","timestamp":1769922171923,"version":"3.49.0"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,10,4]],"date-time":"2013-10-04T00:00:00Z","timestamp":1380844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Advances in the field of skull base surgery aim to maximize anatomical exposure while minimizing patient morbidity. The petroclival region of the skull base presents numerous challenges for surgical access due to the complex anatomy. The transcochlear approach to the region provides adequate access; however, the resection involved sacrifices hearing and results in at least a grade 3 facial palsy. An endoscopic endonasal approach could potentially avoid negative patient outcomes while providing a desirable surgical window in a select patient population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cadaveric study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Endoscopic access to the petroclival region was achieved through an endonasal approach. For comparison, a transcochlear approach to the clivus was performed. Different facets of the dissections, such as bone removal volume and exposed surface area, were computed using computed tomography analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The endoscopic endonasal approach provided a sufficient corridor to the petroclival region with significantly less bone removal and nearly equivalent exposure of the surgical target, thus facilitating the identification of the relevant anatomy. The lateral approach allowed for better exposure from a posterolateral direction until the inferior petrosal sinus; however, the endonasal approach avoided labyrinthine\/cochlear destruction and facial nerve manipulation while providing an anteromedial viewpoint. The endonasal approach also avoided external incisions and cosmetic deficits. The endonasal approach required significant sinonasal resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Endoscopic access to the petroclival region is a feasible approach. It potentially avoids hearing loss, facial nerve manipulation, and cosmetic damage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA. <jats:italic>Laryngoscope<\/jats:italic>, 124:628\u2013636, 2014<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.24378","type":"journal-article","created":{"date-parts":[[2013,10,8]],"date-time":"2013-10-08T15:56:08Z","timestamp":1381247768000},"page":"628-636","source":"Crossref","is-referenced-by-count":8,"title":["Anatomical and computed tomographic analysis of the transcochlear and endoscopic transclival approaches to the petroclival region"],"prefix":"10.1002","volume":"124","author":[{"given":"Eric","family":"Mason","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Center for Cranial Base Surgery Georgia Regents University Augusta Georgia U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Van Rompaey","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Center for Cranial Base Surgery Georgia Regents University Augusta Georgia U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo","family":"Carrau","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery The Ohio State University Medical Center Columbus Ohio U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedict","family":"Panizza","sequence":"additional","affiliation":[{"name":"the Queensland Skull Base Unit, Princess Alexandra Hospital and the School of Medicine The University of Queensland Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. Arturo","family":"Solares","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Center for Cranial Base Surgery Georgia Regents University Augusta Georgia U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,10,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-7091-9183-5_28"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2012.11.011"},{"key":"e_1_2_6_4_1","first-page":"3","article-title":"Petroclival meningiomas","volume":"15","author":"David C","year":"1999","journal-title":"BNI Q"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1057099"},{"key":"e_1_2_6_6_1","first-page":"21","article-title":"Surgery of advanced clival tumors [in Chinese]","volume":"33","author":"Zhang Q","year":"1998","journal-title":"Zhonghua Er Bi Yan Hou Ke Za Zhi"},{"key":"e_1_2_6_7_1","first-page":"217","volume-title":"Endoscopic Sinus Surgery: Anatomy, Three\u2010Dimensional Reconstruction, and Surgical Technique","author":"Wormald P","year":"2008"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1253581"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-211-72283-1_4"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2005.19.1.4"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2011.09.004"},{"key":"e_1_2_6_12_1","first-page":"488","article-title":"Endoscopic endonasal surgery for tumors of petroclival region and infratemporal fossa [in Chinese]","volume":"40","author":"Zhang Q","year":"2005","journal-title":"Zhonghua Er Bi Yan Hou Ke Za Zhi"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3181c5a294"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.3171\/FOC.2008.25.12.E7"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199911000-00058"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.3342\/ceo.2008.1.2.53"},{"key":"e_1_2_6_17_1","first-page":"31","article-title":"Surgery of petroclival tumours: a series of 45 cases","volume":"12","author":"Mahapatra A","year":"2008","journal-title":"Pan Arab J Neurosurg"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2012.10.023"},{"issue":"6","key":"e_1_2_6_19_1","first-page":"S1","article-title":"Temporal bone and lateral skull base malignancy: experience and results with 81 patients","volume":"19","author":"Manolidis S","year":"1998","journal-title":"Otol Neurotol"},{"issue":"6","key":"e_1_2_6_20_1","first-page":"3","article-title":"Lateral approaches to the clivus","volume":"17","author":"Falcioni M","year":"1997","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199607000-00044"},{"key":"e_1_2_6_22_1","first-page":"240","article-title":"Unilateral secondary (acquired) postmastoidectomy low\u2010set ear: postoperative complication with potential functional and cosmetic implications","volume":"38","author":"Ali M","year":"2009","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.3171\/2012.6.FOCUS12168"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2013.01.017"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1413-86702004000500009"},{"key":"e_1_2_6_26_1","first-page":"71","article-title":"Pedicled extranasal flaps in skull base reconstruction","volume":"74","author":"Kim G","year":"2013","journal-title":"Adv Otorhinolaryngol"},{"key":"e_1_2_6_27_1","first-page":"42","article-title":"Nasoseptal flap","volume":"74","author":"Pinheiro\u2010Neto C","year":"2013","journal-title":"Adv Otorhinolaryngol"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.24378","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.24378","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.24378","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.24378","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T15:28:33Z","timestamp":1692545313000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.24378"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10,4]]},"references-count":26,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2014,3]]}},"alternative-id":["10.1002\/lary.24378"],"URL":"https:\/\/doi.org\/10.1002\/lary.24378","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10,4]]}}}