The expanded endonasal approach: a fully endoscopic transnasal approach and resection of the odontoid process: technical case report.
The 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.
Kassam
Amin B
AB
Department of Neurological Surgery, University of Pittsburgh and Medical Center, Presbyterian University Hospital, Pittsburgh, Pennsylvania 15213, USA. kassamab@upmc.edu
Snyderman
Carl
C
Gardner
Paul
P
Carrau
Ricardo
R
Spiro
Richard
R
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications; D019299:Decompression, Surgical / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D009666:Nose / Q000601:surgery; D009809:Odontoid Process / Q000473:pathology / Q000601:surgery*; D013117:Spinal Cord Compression / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome