# Endoscopy-assisted high cervical anterolateral retropharyngeal approach to clivus: a cadaveric study

## TL;DR

This study introduces a new endoscope-assisted surgical approach to access the clivus and craniocervical junction using cadaveric models.

## Contribution

The novel high cervical anterolateral retropharyngeal approach is described with step-by-step endoscopic guidance.

## Key findings

- The modified approach was demonstrated on cadavers in nine distinct steps.
- Neurovascular structures and their relationships were mapped during each surgical step.
- The advantages and disadvantages of the new approach were compared to existing surgical methods.

## Abstract

The surgical management of pathologies involving the clivus and craniocervical junction has always been considered a complex procedure because of the deeply located surgical targets and the surrounding complex neural and vascular anatomical structures. The most commonly used approaches to reach this area are the transnasal, transoral, and transcervical approaches.

This approach was performed unilaterally on five cadaver heads and bilaterally on one cadaver head.

We described a modified endoscope-assisted high cervical anterolateral retropharyngeal approach in which each stage of the procedure was demonstrated on human cadavers in a step-by-step manner using endoscopic camera views. This approach was broken down into nine steps. The neurovascular structures encountered at each step and their relationships with each other are demonstrated.

The advantages and disadvantages of our modified approach were compared to the conventional transcervical, transoral, and endoscopic endonasal approaches.