title: Cervical C2 osteoma, unusual presentation and transoral approach for complete excision.
abstract: BACKGROUND
  Osteoid osteomas are benign tumors of the bone with 10% occurring in the spine. The authors discuss a case of a 70-year-old lady with an unusual presentation of a cervical C2 osteoma. The presentation was with mild dysphagia and pressure symptoms behind the left ear similar to earache experienced on an aircraft at high altitude with no hearing loss.
  
  
  OBJECTIVE
  The authors postulate that with the appropriate preoperative imaging, operation, and postoperative care, patients with C2 body osteomas can make a good recovery.
  
  
  METHODS
  This is the case of a patient with a C2 osteoma.
  
  
  METHODS
  A swelling in the left tonsillar region was noted on examination. A computed tomography and magnetic resonance imaging scans revealed a lesion associated with the left half of the body of C2. En bloc excision was performed via the transoral route.
  
  
  RESULTS
  The patient made a successful recovery.
  
  
  CONCLUSIONS
  C2 osteomas are rare and the mode of presentation of the patient discussed is unique. Despite this, with careful planning, the transoral approach to upper cervical region is a direct and safe route for high cervical and base of skull pathology.
authors.affiliation: Victor Horsley Department of Neurosurgery, The National Hospital Neurology and Neurosurgery, Queen Square, London WC1N 3BG, United Kingdom.
authors.forename: Babak
authors.initials: B
authors.lastname: Arvin
authors.forename: Jaykar R
authors.initials: JR
authors.lastname: Panchmatia
authors.forename: Adrian T H
authors.initials: AT
authors.lastname: Casey
mesh_terms: D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D003680:Deglutition Disorders / Q000209:etiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D019637:Orthopedic Procedures / Q000379:methods*; D010016:Osteoma / Q000473:pathology / Q000601:surgery*; D013125:Spinal Neoplasms / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed