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 language | English |
|---|---|
| Journal | Neurosurgery |
| Volume | 63 |
| Issue number | 1 Suppl 1 |
| Publication status | Published - Jul 1 2008 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Surgery
- Clinical Neurology
Cite this
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 journal › Article
}
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.
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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 -