Endoscopic Transnasal Odontoidectomy

• Type of Material: Article
• Authors: Jeffrey J Falco, Augusta University; Arturo C Solares, Emory University; Camilo Reyes, Augusta University
• Language: English
• Date: 2020-09-17
• Publisher: THIEME MEDICAL PUBL INC
• Publication Version: Final Published Version
• Copyright Statement: The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ )
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1055/s-0040-1705161
• Title of Journal or Parent Work: JOURNAL OF NEUROLOGICAL SURGERY PART B-SKULL BASE
• Volume: 82
• Issue: Suppl 1
• Start Page: S8
• End Page: S9
• Keywords: Surgery; anterior skull base; odontoidectomy; endoscopic surgery; Life Sciences & Biomedicine; Neurosciences & Neurology; Clinical Neurology; basilar invasion; platybasia; Science & Technology
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Objectives âthe video demonstrates the steps for an endoscopic transnasal approach for resection of the odontoid causing platybasia with basilar invasion. Design âthe video reviews the clinical presentation, preoperative workup and imaging, patient positioning, technical nuances of the procedure, reconstruction, and clinical outcomes including postoperative imaging. Setting âthe surgery was performed by a skull base team including otolaryngologists and neurological surgeons at a large regional tertiary care facility. Participants â A 59-year-old female with the Chiari I malformation with history of multiple revision cervical spinal surgeries presents with neck pain. Preoperative imaging showed a hypoplastic clivus and platybasia with basilar invasion. Main Outcome Measures âthe main outcome measures consist of safely removing the odontoid with appropriate closure, reversal of the patient symptoms, and prevention of both operative complications and ventral compression of the brainstem. Results âthe patient's neck pain improved. There were no intraoperative or postoperative complications besides anterior rightward nasal septal deviation causing unilateral nasal obstruction. A septoplasty was performed to correct the septal deviation 6 months after the initial procedure. Conclusions âthe endoscopic transnasal approach to the resection of odontoid is a safe and effective treatment to address basilar invasion and ventral compression of the brainstem. The link to the video can be found at: Https://youtu.be/m_c3-Vn-l80.