The Expanded Endonasal Approach: A Fully Endoscopic Transnasal Approach and Resection of the Odontoid Process: Technical Case Report

Operative Neurosurgery - Tập 57 Số suppl_1 - Trang E213-E213 - 2005
Amin Kassam1, Carl H. Snyderman2, Paul A. Gardner3, Ricardo L. Carrau2, Richard M. Spiro3
1Departments of Neurological Surgery and Otolaryngology, University of Pittsburgh and University of Pittsburgh Medical Center, Presbyterian University Hospital, Pittsburgh, Pennsylvania
2Department of Neurological Surgery and Otolaryngology, University of Pittsburgh and University of Pittsburgh Medical Center, Presbyterian University Hospital, Pittsburgh, Pennsylvania
3Department of Neurological Surgery, University of Pittsburgh and University of Pittsburgh Medical Center, Presbyterian University Hospital, Pittsburgh, Pennsylvania

Tóm tắt

AbstractTHE TRANSORAL APPROACH to the odontoid process is considered the “gold standard” for resection of extradural lesions at this location. A completely transnasal endoscopic approach is feasible based on anatomic studies and our experience with the expanded endonasal approach for neoplasms of the cranial base. An illustrative case is presented to demonstrate the technical details of a fully transnasal completely endoscopic approach for the resection of the odontoid process. A 73-year-old woman with a long-standing history of rheumatoid arthritis presented with progressive cervicomedullary compression. Complete resection of the odontoid was achieved with no significant morbidity. This is the first reported case of a completely endoscopic resection of the odontoid using a fully transnasal route. The report demonstrates the feasibility of this approach and larger clinical series with long-term follow-up will be needed to determine the reproducibility and validation of any potential benefits.

Từ khóa


Tài liệu tham khảo

Alfieri, 2002, Endoscopic endonasal approach to the ventral cranio-cervical junction: Anatomical study, Acta Neurochir (Wien), 144, 219, 10.1007/s007010200029

Apuzzo, 1978, Transoral exposure of the atlantoaxial region, Neurosurgery, 3, 201, 10.1227/00006123-197809000-00012

Crockard, 1995, Transoral surgery: Some lessons learned, Br J Neurosurg, 9, 283, 10.1080/02688699550041304

Crockard, 1986, Transoral decompression and posterior fusion for rheumatoid atlanto-axial subluxation, J Bone Joint Surg Br, 68B, 350, 10.1302/0301-620X.68B3.3733795

DiLorenzo, 1982, Craniocervical junction malformations: Clinicoradiological findings, long-term results, and surgical indications in 63 cases, J Neurosurg, 57, 603, 10.3171/jns.1982.57.5.0603

Estridge, 1967, Transoral fusion of odontoid fracture: Case report, J Neurosurg, 27, 462, 10.3171/jns.1967.27.5.0462

Frempong-Boadu, 2002, Endoscopically assisted transoral-transpharyngeal approach to the craniovertebral junction, Neurosurgery, 51, 60

Goel, 1998, Basilar invagination: A study based on 190 surgically treated patients, J Neurosurg, 88, 962, 10.3171/jns.1998.88.6.0962

Greenberg, 1968, Transoral decompression of atlanto-axial dislocation due to odontoid hypoplasia: Report of two cases, J Neurosurg, 28, 266, 10.3171/jns.1968.28.3.0266

Hadley, 1989, The transoral approach to the superior cervical spine: A review of 53 cases of extradural cervicomedullary compression, J Neurosurg, 71, 16, 10.3171/jns.1989.71.1.0016

Kingdom, 1995, Transoral-transpharyngeal approach to the craniocervical junction, Otolaryngol Head Neck Surg, 113, 393, 10.1016/S0194-5998(95)70074-9

Lee, 1985, Transoral anterior decompression for treatment of unreducible atlantoaxial dislocations, Surg Neurol, 23, 244, 10.1016/0090-3019(85)90089-8

Menezes, 1988, Transoral-transpharyngeal approach to the anterior craniocervical junction: Ten-year experience with 72 patients, J Neurosurg, 69, 895, 10.3171/jns.1988.69.6.0895

Menezes, 1980, Craniocervical abnormalities: A comprehensive surgical approach, J Neurosurg, 53, 444, 10.3171/jns.1980.53.4.0444

Pasztor, 1980, Transoral surgery for basilar impression, Surg Neurol, 14, 473

Shaha, 1993, Transoral-transpharyngeal approach to the upper cervical vertebrae, Am J Surg, 166, 336, 10.1016/S0002-9610(05)80327-7

Snyderman, 2004, Sources of registration error with image guidance systems during endoscopic anterior cranial base surgery, Otolaryngol Head Neck Surg, 131, 145, 10.1016/j.otohns.2004.03.002

Spetzler, 1988, The transoral approach to the anterior superior cervical spine: A review of 29 cases, Acta Neurochir Suppl (Wien), 43, 69

Vishteh, 1999, Bilateral sagittal split mandibular osteotomies as an adjunct to the transoral approach to the anterior craniovertebral junction: Technical note, J Neurosurg, 90, 267

Welch, 2003, Endoscopically assisted transoral-transpharyngeal approach to the craniovertebral junction, Neurosurgery, 52, 1511, 10.1227/01.NEU.0000068353.22859.CB

Yang, 1999, Clinical results of the transoral operation for lesions of the craniovertebral junction and its abnormalities, Surg Neurol, 51, 16, 10.1016/S0090-3019(97)00501-6

Thông tin
Thông tin xuất bản

Operative Neurosurgery

Tập 57 Số suppl_1

E213-E213

Thông tin tác giả