title: Endoscopic endonasal odontoidectomy in a child with chronic type 3 atlantoaxial rotatory fixation: case report and literature review.
abstract: BACKGROUND
  Although the transoral transpharyngeal approach has been the standard approach to decompress the odontoid process, it bears some disadvantages including risk of infection, prolonged intubation or tracheostomy, need for nasogastric tube feeding, extended hospitalization, and possible effects of phonation. The endoscopic transnasal approach is a viable alternative, managing to avoid some of the pitfalls of the more accepted transoral transpharyngeal approach. However, there have only been a handful of adult cases and only three pediatric cases.
  
  
  METHODS
  We present the case of a 10-year-old girl with a chronic type 3 atlantoaxial rotator fixation and significant spinal cord compression from basilar invagination and a displaced odontoid process. We performed an endoscopic endonasal odontoidectomy prior to posterior occiptocervical fusion on the patient. She was neurologically intact with a well-healed wound at 7-month follow-up.
authors: Neuro-Spine Program, Division of Pediatric Neurosurgery, Department of Neurosurgery, Texas Children's Hospital, Baylor College of Medicine, 6621 Fannin Street CCC 1230.01, 12th Floor, Houston, TX 77030, USA.
authors: Akash J
authors: AJ
authors: Patel
authors: Jerome
authors: J
authors: Boatey
authors: James
authors: J
authors: Muns
authors: Robert J
authors: RJ
authors: Bollo
authors: William E
authors: WE
authors: Whitehead
authors: Carla M
authors: CM
authors: Giannoni
authors: Andrew
authors: A
authors: Jea
mesh_terms: D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D002648:Child; D019299:Decompression, Surgical / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009809:Odontoid Process / Q000000981:diagnostic imaging / Q000601:surgery*; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed