{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T01:19:46Z","timestamp":1781140786890,"version":"3.54.1"},"reference-count":13,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,5,15]],"date-time":"2020-05-15T00:00:00Z","timestamp":1589500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>The contralateral transmaxillary (CTM) approach is a new surgical approach that improves the surgical trajectory relative to the petrous segment of the internal carotid artery (ICA). Here, we present our clinical experience with the CTM approach to the petroclival region of the skull base.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of 29 patients who underwent a CTM approach for skull base pathology from 2015 to 2020 was performed. Assessment of gross total resection (GTR) was based on postoperative imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The male:female ratio was 15:14, with an average age of 52\u2009years (range = 19\u201378\u2009years). Diagnoses included: 12 chondrosarcomas, 11 chordomas, two meningiomas, one schwannoma, one metastasis, one petrous apicitis, and one arachnoid cyst. CTM was performed in addition to a transclival approach and ipsilateral transpterygoid approach in all patients. Reconstruction of surgical defects included a vascularized flap in all but two patients: 24 nasoseptal flaps and three lateral nasal wall flaps. The reconstructive flap was on the same side as the CTM approach in 22 of 28 (79%) patients. There were no ICA injuries. In a subset of patients with chondromatous tumors, GTR of the targeted area was achieved in 16 of 22 (73%) evaluable chondromatous tumors. With a median follow\u2010up of 13\u2009months, 64% of these patients are without disease or dead of other causes; the remainder are alive with disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The CTM approach improves the degree of resection of skull base tumors involving the petroclival region using an endoscopic endonasal approach and may minimize risk to the ICA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:294\u2013298, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28740","type":"journal-article","created":{"date-parts":[[2020,5,16]],"date-time":"2020-05-16T07:19:08Z","timestamp":1589613548000},"page":"294-298","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Experience With the Endoscopic Contralateral Transmaxillary Approach to the Petroclival Skull Base"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8920-4522","authenticated-orcid":false,"given":"Carl H.","family":"Snyderman","sequence":"first","affiliation":[{"name":"Department of Otolaryngology University of Pittsburgh School of Medicine  Pittsburgh PA"},{"name":"Center for Cranial Base Surgery University of Pittsburgh Medical Center  Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Center for Cranial Base Surgery University of Pittsburgh Medical Center  Pittsburgh PA"},{"name":"Department of Neurological Surgery University of Pittsburgh School of Medicine  Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1180-5854","authenticated-orcid":false,"given":"Eric W.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Pittsburgh School of Medicine  Pittsburgh PA"},{"name":"Center for Cranial Base Surgery University of Pittsburgh Medical Center  Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0669-810X","authenticated-orcid":false,"given":"Juan C.","family":"Fernandez\u2010Miranda","sequence":"additional","affiliation":[{"name":"Center for Cranial Base Surgery University of Pittsburgh Medical Center  Pittsburgh PA"},{"name":"Department of Neurological Surgery University of Pittsburgh School of Medicine  Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benita","family":"Valappil","sequence":"additional","affiliation":[{"name":"Center for Cranial Base Surgery University of Pittsburgh Medical Center  Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2001.10.3.13"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22448"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otot.2006.01.004"},{"key":"e_1_2_6_5_1","first-page":"310","volume-title":"Transnasal Endoscopic Skull Base and Brain Surgery","author":"Snyderman CH","year":"2011"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.3171\/2017.4.JNS162483"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20975"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21808"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.3171\/2018.6.JNS181117"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24256"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23415"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e31825ea3e0"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.3171\/2018.1.JNS171972"},{"key":"e_1_2_6_14_1","first-page":"ons261","article-title":"Carotid artery injury during endoscopic endonasal skull base surgery: incidence and outcomes","volume":"73","author":"Gardner PA","year":"2013","journal-title":"Neurosurgery"}],"container-title":["The 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