Endoscopic transnasal transclival odontoidectomy: a new approach to decompression: technical case report.

Jau Ching Wu, Wen Cheng Huang, Henrich Cheng, Muh Lii Liang, Ching Yin Ho, Tai-Tong Wong, Yang Hsin Shih, Yu Shu Yen

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

OBJECTIVE: Endoscopic transnasal transclival resection of the odontoid process is less invasive than the standard transoral odontoidectomy. In this article, we describe our techniques, which are less invasive but provide successful decompression. CLINICAL PRESENTATION: From September 2004 to April 2007, three consecutive patients with basilar invagination and instability in the craniovertebral junction were enrolled. The causes for the invagination and instability included rheumatoid arthritis in two patients and trauma in one patient, and all patients presented with myelopathy and quadriparesis before intervention. INTERVENTION: All three patients underwent an endoscopic transnasal transclival approach for anterior decompression and resection of the displaced odontoid process and pannus to decompress the underlying medulla. Subsequently, they received occipitocervical fixation by lateral mass screws and bone fusion to ensure stability. Remarkable neurological recovery was observed after surgery in all patients, and no adverse effects were noted. CONCLUSION: Compared with the standard transoral approach, the transnasal transclival endoscopic approach for decompressing basilar invagination is a feasible and effective alternative that avoids common disadvantages like prolonged intubation, excessive tongue retraction, and the need for palatal incision.

Original languageEnglish
JournalNeurosurgery
Volume63
Issue number1 Suppl 1
Publication statusPublished - Jul 1 2008
Externally publishedYes

Fingerprint

Decompression
Odontoid Process
Bone Screws
Quadriplegia
Spinal Cord Diseases
Tongue
Intubation
Rheumatoid Arthritis
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Wu, J. C., Huang, W. C., Cheng, H., Liang, M. L., Ho, C. Y., Wong, T-T., ... Yen, Y. S. (2008). Endoscopic transnasal transclival odontoidectomy: a new approach to decompression: technical case report. Neurosurgery, 63(1 Suppl 1).

Endoscopic transnasal transclival odontoidectomy : a new approach to decompression: technical case report. / Wu, Jau Ching; Huang, Wen Cheng; Cheng, Henrich; Liang, Muh Lii; Ho, Ching Yin; Wong, Tai-Tong; Shih, Yang Hsin; Yen, Yu Shu.

In: Neurosurgery, Vol. 63, No. 1 Suppl 1, 01.07.2008.

Research output: Contribution to journalArticle

Wu, JC, Huang, WC, Cheng, H, Liang, ML, Ho, CY, Wong, T-T, Shih, YH & Yen, YS 2008, 'Endoscopic transnasal transclival odontoidectomy: a new approach to decompression: technical case report.', Neurosurgery, vol. 63, no. 1 Suppl 1.
Wu, Jau Ching ; Huang, Wen Cheng ; Cheng, Henrich ; Liang, Muh Lii ; Ho, Ching Yin ; Wong, Tai-Tong ; Shih, Yang Hsin ; Yen, Yu Shu. / Endoscopic transnasal transclival odontoidectomy : a new approach to decompression: technical case report. In: Neurosurgery. 2008 ; Vol. 63, No. 1 Suppl 1.
@article{696cf95fe883458486967b111a1d6a16,
title = "Endoscopic transnasal transclival odontoidectomy: a new approach to decompression: technical case report.",
abstract = "OBJECTIVE: Endoscopic transnasal transclival resection of the odontoid process is less invasive than the standard transoral odontoidectomy. In this article, we describe our techniques, which are less invasive but provide successful decompression. CLINICAL PRESENTATION: From September 2004 to April 2007, three consecutive patients with basilar invagination and instability in the craniovertebral junction were enrolled. The causes for the invagination and instability included rheumatoid arthritis in two patients and trauma in one patient, and all patients presented with myelopathy and quadriparesis before intervention. INTERVENTION: All three patients underwent an endoscopic transnasal transclival approach for anterior decompression and resection of the displaced odontoid process and pannus to decompress the underlying medulla. Subsequently, they received occipitocervical fixation by lateral mass screws and bone fusion to ensure stability. Remarkable neurological recovery was observed after surgery in all patients, and no adverse effects were noted. CONCLUSION: Compared with the standard transoral approach, the transnasal transclival endoscopic approach for decompressing basilar invagination is a feasible and effective alternative that avoids common disadvantages like prolonged intubation, excessive tongue retraction, and the need for palatal incision.",
author = "Wu, {Jau Ching} and Huang, {Wen Cheng} and Henrich Cheng and Liang, {Muh Lii} and Ho, {Ching Yin} and Tai-Tong Wong and Shih, {Yang Hsin} and Yen, {Yu Shu}",
year = "2008",
month = "7",
day = "1",
language = "English",
volume = "63",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "1 Suppl 1",

}

TY - JOUR

T1 - Endoscopic transnasal transclival odontoidectomy

T2 - a new approach to decompression: technical case report.

AU - Wu, Jau Ching

AU - Huang, Wen Cheng

AU - Cheng, Henrich

AU - Liang, Muh Lii

AU - Ho, Ching Yin

AU - Wong, Tai-Tong

AU - Shih, Yang Hsin

AU - Yen, Yu Shu

PY - 2008/7/1

Y1 - 2008/7/1

N2 - OBJECTIVE: Endoscopic transnasal transclival resection of the odontoid process is less invasive than the standard transoral odontoidectomy. In this article, we describe our techniques, which are less invasive but provide successful decompression. CLINICAL PRESENTATION: From September 2004 to April 2007, three consecutive patients with basilar invagination and instability in the craniovertebral junction were enrolled. The causes for the invagination and instability included rheumatoid arthritis in two patients and trauma in one patient, and all patients presented with myelopathy and quadriparesis before intervention. INTERVENTION: All three patients underwent an endoscopic transnasal transclival approach for anterior decompression and resection of the displaced odontoid process and pannus to decompress the underlying medulla. Subsequently, they received occipitocervical fixation by lateral mass screws and bone fusion to ensure stability. Remarkable neurological recovery was observed after surgery in all patients, and no adverse effects were noted. CONCLUSION: Compared with the standard transoral approach, the transnasal transclival endoscopic approach for decompressing basilar invagination is a feasible and effective alternative that avoids common disadvantages like prolonged intubation, excessive tongue retraction, and the need for palatal incision.

AB - OBJECTIVE: Endoscopic transnasal transclival resection of the odontoid process is less invasive than the standard transoral odontoidectomy. In this article, we describe our techniques, which are less invasive but provide successful decompression. CLINICAL PRESENTATION: From September 2004 to April 2007, three consecutive patients with basilar invagination and instability in the craniovertebral junction were enrolled. The causes for the invagination and instability included rheumatoid arthritis in two patients and trauma in one patient, and all patients presented with myelopathy and quadriparesis before intervention. INTERVENTION: All three patients underwent an endoscopic transnasal transclival approach for anterior decompression and resection of the displaced odontoid process and pannus to decompress the underlying medulla. Subsequently, they received occipitocervical fixation by lateral mass screws and bone fusion to ensure stability. Remarkable neurological recovery was observed after surgery in all patients, and no adverse effects were noted. CONCLUSION: Compared with the standard transoral approach, the transnasal transclival endoscopic approach for decompressing basilar invagination is a feasible and effective alternative that avoids common disadvantages like prolonged intubation, excessive tongue retraction, and the need for palatal incision.

UR - http://www.scopus.com/inward/record.url?scp=62149142877&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=62149142877&partnerID=8YFLogxK

M3 - Article

C2 - 18728615

AN - SCOPUS:62149142877

VL - 63

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 1 Suppl 1

ER -