Journal of Craniovertebral Junction and Spine

ORIGINAL ARTICLE
Year
: 2023  |  Volume : 14  |  Issue : 1  |  Page : 11--15

The carotid sheath route: An option to approach retrocarotid prespinal tumors with paravertebral extension


Filippo Gagliardi1, Leone Giordano2, Marzia Medone1, Silvia Snider1, Francesca Roncelli1, Edoardo Pompeo1, Pietro Mortini1 
1 Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
2 Department of Otorhinolaryngology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy

Correspondence Address:
Filippo Gagliardi
Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132
Italy

Background: The elective route to approach paravertebral lesions growing into the anterolateral lodge of the neck is widely recognized as the prespinal route with its two major variants. Recently, attention has been focused on the possibility of opening the inter-carotid-jugular window in case of reparative surgery for traumatic brachial plexus injury. Aims: For the first time, the authors validate the clinical application of the carotid sheath route in the surgical treatment of paravertebral lesions expanding into the anterolateral lodge of the neck. Methods: A microanatomic study was conducted to collect anthropometric measurements. The technique was illustrated in a clinical setting. Results: The opening of the inter-carotid-jugular surgical window allows additional access to the prevertebral and periforaminal space. It optimizes the operability on the prevertebral compartment, compared to the retro-sternocleidomastoid (SCM) approach, and on the periforaminal compartment, compared to the standard pre-SCM approach. The surgical control of the vertebral artery is comparable to that obtained with the retro-SCM approach, while the control of the esophagotracheal complex and the retroesophageal space is comparable to the pre-SCM approach. The risk profile on the inferior thyroid vessels, recurrent nerve, and sympathetic chain is superimposable to the pre-SCM approach. Conclusions: The carotid sheath route is a safe and effective option to approach prespinal lesions with retrocarotid monolateral paravertebral extension.


How to cite this article:
Gagliardi F, Giordano L, Medone M, Snider S, Roncelli F, Pompeo E, Mortini P. The carotid sheath route: An option to approach retrocarotid prespinal tumors with paravertebral extension.J Craniovert Jun Spine 2023;14:11-15


How to cite this URL:
Gagliardi F, Giordano L, Medone M, Snider S, Roncelli F, Pompeo E, Mortini P. The carotid sheath route: An option to approach retrocarotid prespinal tumors with paravertebral extension. J Craniovert Jun Spine [serial online] 2023 [cited 2023 Mar 22 ];14:11-15
Available from: https://www.jcvjs.com/article.asp?issn=0974-8237;year=2023;volume=14;issue=1;spage=11;epage=15;aulast=Gagliardi;type=0