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Endoscopic endonasal resection of the odontoid process as a standalone decompressive procedure for basilar invagination in Chiari type I malformation.
Minim Invasive Neurosurg. 2011 Aug; 54(4):179-82.MI

Abstract

BACKGROUND

The expanded endonasal approach of the cranio-cervical junction provides comfortable working space while avoiding some of the disadvantages of the transoral route. We report a purely endonasal endoscopic resection of the odontoid process for basilar invagination in a patient with a Chiari type I malformation, without posterior decompression or fusion.

CASE REPORT

A 54-year-old female patient presented with cranial nerve and brainstem deficits. CT and MRI showed a Chiari type I malformation and compression of the medulla by basilar invagination of the odontoid process. The tip of the latter was displaced up to the bulbo-pontine sulcus. The odontoid process was resected via the expanded endoscopic endonasal approach, without additional posterior decompression or fusion. The post-operative course was uneventful, including the absence of velopharyngeal insufficiency. Neurological deficits regressed rapidly. The preoperative cervical pain virtually disappeared. At 9 months follow-up, the patient had normal activity with minimal residual neurological deficits. Post-op dynamic radiography and CT showed stability of the cranio-cervical junction.

CONCLUSION

Decompression of the bulbomedullary junction by purely endoscopic transnasal resection of the odontoid process is well tolerated and efficient. Immediate stabilization is not mandatory in all cases of congenital causes of basilar invagination.

Authors+Show Affiliations

Department of Neurosurgery, Centre Hospitalier de l'Université de Montréal, Montréal, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

21922447

Citation

Scholtes, F, et al. "Endoscopic Endonasal Resection of the Odontoid Process as a Standalone Decompressive Procedure for Basilar Invagination in Chiari Type I Malformation." Minimally Invasive Neurosurgery : MIN, vol. 54, no. 4, 2011, pp. 179-82.
Scholtes F, Signorelli F, McLaughlin N, et al. Endoscopic endonasal resection of the odontoid process as a standalone decompressive procedure for basilar invagination in Chiari type I malformation. Minim Invasive Neurosurg. 2011;54(4):179-82.
Scholtes, F., Signorelli, F., McLaughlin, N., Lavigne, F., & Bojanowski, M. W. (2011). Endoscopic endonasal resection of the odontoid process as a standalone decompressive procedure for basilar invagination in Chiari type I malformation. Minimally Invasive Neurosurgery : MIN, 54(4), 179-82. https://doi.org/10.1055/s-0031-1283168
Scholtes F, et al. Endoscopic Endonasal Resection of the Odontoid Process as a Standalone Decompressive Procedure for Basilar Invagination in Chiari Type I Malformation. Minim Invasive Neurosurg. 2011;54(4):179-82. PubMed PMID: 21922447.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic endonasal resection of the odontoid process as a standalone decompressive procedure for basilar invagination in Chiari type I malformation. AU - Scholtes,F, AU - Signorelli,F, AU - McLaughlin,N, AU - Lavigne,F, AU - Bojanowski,M W, Y1 - 2011/09/15/ PY - 2011/9/17/entrez PY - 2011/9/17/pubmed PY - 2012/3/2/medline SP - 179 EP - 82 JF - Minimally invasive neurosurgery : MIN JO - Minim Invasive Neurosurg VL - 54 IS - 4 N2 - BACKGROUND: The expanded endonasal approach of the cranio-cervical junction provides comfortable working space while avoiding some of the disadvantages of the transoral route. We report a purely endonasal endoscopic resection of the odontoid process for basilar invagination in a patient with a Chiari type I malformation, without posterior decompression or fusion. CASE REPORT: A 54-year-old female patient presented with cranial nerve and brainstem deficits. CT and MRI showed a Chiari type I malformation and compression of the medulla by basilar invagination of the odontoid process. The tip of the latter was displaced up to the bulbo-pontine sulcus. The odontoid process was resected via the expanded endoscopic endonasal approach, without additional posterior decompression or fusion. The post-operative course was uneventful, including the absence of velopharyngeal insufficiency. Neurological deficits regressed rapidly. The preoperative cervical pain virtually disappeared. At 9 months follow-up, the patient had normal activity with minimal residual neurological deficits. Post-op dynamic radiography and CT showed stability of the cranio-cervical junction. CONCLUSION: Decompression of the bulbomedullary junction by purely endoscopic transnasal resection of the odontoid process is well tolerated and efficient. Immediate stabilization is not mandatory in all cases of congenital causes of basilar invagination. SN - 1439-2291 UR - https://www.unboundmedicine.com/medline/citation/21922447/Endoscopic_endonasal_resection_of_the_odontoid_process_as_a_standalone_decompressive_procedure_for_basilar_invagination_in_Chiari_type_I_malformation_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0031-1283168 DB - PRIME DP - Unbound Medicine ER -