{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:10:25Z","timestamp":1792069825045,"version":"4.4.0"},"reference-count":49,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,7,7]],"date-time":"2016-07-07T00:00:00Z","timestamp":1467849600000},"content-version":"vor","delay-in-days":67,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To develop an endoscopic transnasal approach to atlas tumors and study its practicability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This article comprises two components: an illustrative case report and observational data on 50 volunteers. As to the case report, a 34\u2009year old man presented with occipital pain for more than 3\u2009months and underwent systematic investigation in <jats:styled-content style=\"fixed-case\">Q<\/jats:styled-content>ilu <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>ospital of <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>handong <jats:styled-content style=\"fixed-case\">U<\/jats:styled-content>niversity. <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> scans showed bony destruction in the craniovertebral junction (<jats:styled-content style=\"fixed-case\">CVJ<\/jats:styled-content>) suggestive of tumor. Via an endoscopic transnasal approach to the suspected atlas tumor through the inferior nasal meatus, a <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>allini biopsy needle was used to obtain tissue for examination. The procedure was performed endoscopically with double orientation <jats:styled-content style=\"fixed-case\">X<\/jats:styled-content>\u2010ray guidance and coaxial technology after establishing the shortest distance for the biopsy track and range of target tissue and was assisted by manual palpation. As to the observational data, 50 volunteers underwent atlas\u2010related morphometric image measurement using gemstone <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> equipment. Biopsy track angles, range for biopsy of the atlas and biopsy track distances were measured by a blinded operator on <jats:styled-content style=\"fixed-case\">CT images<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Case report: pathological examination of the biopsy resulted in diagnosis of a chordoma. There were no complications such as bleeding, infection or spinal cord injury. One month later, the patient underwent tumor resection and reconstruction in other hospital and the diagnosis of chordoma was confirmed by pathological examination of the resected specimen. Observational data: measurements obtained from <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> scans of the 50 volunteers were as follows. Biopsy track angles: mean leaning inside angle 3.53\u00b0\u2009\u00b1\u20090.39\u00b0 and mean posterior slope angle 13.05\u00b0\u2009\u00b1\u20091.39\u00b0. Range for atlas biopsy: transverse diameter 11.84\u2009\u00b1\u20091.24\u2009mm and longitudinal diameter 9.67\u2009\u00b1\u20090.90\u2009mm. Biopsy track distances: from atlas to nostril, and to anterior and posterior edges of the inferior turbinate mucosa were 94.52\u2009\u00b1\u20095.03 mm, 78.21\u2009\u00b1\u20094.63 mm, and 33.51\u2009\u00b1\u20093.13\u2009mm, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An endoscopic transnasal approach enables biopsy and diagnosis of tumors in the anterior arch of the atlas. Relevant measurements were obtained by assessing <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> scans of 50 volunteers to assist operators to determine the effective and safe range for transnasal atlas biopsy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12232","type":"journal-article","created":{"date-parts":[[2016,7,7]],"date-time":"2016-07-07T11:04:11Z","timestamp":1467889451000},"page":"179-185","source":"Crossref","is-referenced-by-count":2,"title":["Transnasal Endoscopic Biopsy Approach to Atlas Tumor with <scp>X<\/scp>\u2010ray Assisted and Related Radiographic Measure"],"prefix":"10.1111","volume":"8","author":[{"given":"Zhen\u2010feng","family":"Li","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Qilu Hospital Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xian\u2010hao","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Qilu Hospital Shandong 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