title: The selective odontoidectomy: endoscopic endonasal approach to the craniocervical junction.
abstract: OBJECTIVE
  The resection of the odontoid process via an extended endoscopic endonasal approach has been recently proposed as an alternative to the microscopic transoral method. We aimed to delineate a minimally invasive endoscopic transnasal odontoidectomy and to describe the endoscopic anatomy of the anterior craniovertebral junction (CVJ).
  
  
  METHODS
  The anterior CVJ of 14 fresh adult cadavers were selectively accessed via a binostril endoscopic endonasal approach using 0- and 30-degree endoscopes.
  
  
  RESULTS
  The nasopharynx was widely exposed without removing any of the turbinates and without performing a sphenoidotomy. Occipital condyles and lateral masses of the C1 vertebra have been exposed inferiorly at lateral margins of the exposure, in addition to the foramen lacerum, which came into view at the superolateral corner of the operative field. The anterior arch of C1 and the upper 1.5 cm of the odontoid process of C2 have been removed via a minimally invasive endoscopic transnasal approach in all dissections.
  
  
  CONCLUSIONS
  We propose the selective odontoidectomy as a minimally invasive method for the endoscopic endonasal removal of the odontoid process. By using this approach, turbinates and the sphenoid sinus remain unharmed. In addition, this approach may be used in exposing pathologies situated laterally at the anterior CVJ, such as the lateral masses of atlas and occipital condyles.
authors.affiliation: From the *Bakirkoy Research and Training Hospital for Neurology, Neurosurgery, and Psychiatry, 2nd Neurosurgery Clinic, Istanbul, Turkey; †Istanbul Headquarters of Forensic Medicine Institute, Ministry of Justice, Istanbul, Turkey; and ‡Istanbul University, Cerrahpaşa Medical Faculty, Department of Neurosurgery, Istanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Tanriverdi
authors.forename: Bekir
authors.initials: B
authors.lastname: Tugcu
authors.forename: Omur
authors.initials: O
authors.lastname: Gunaldi
authors.forename: Sevki Serhat
authors.initials: SS
authors.lastname: Baydin
authors.forename: Bulent Timur
authors.initials: BT
authors.lastname: Demirgil
authors.forename: Bulent
authors.initials: B
authors.lastname: Sam
authors.forename: Baris
authors.initials: B
authors.lastname: Kucukyuruk
authors.forename: Necmettin
authors.initials: N
authors.lastname: Tanriover
mesh_terms: D000328:Adult; D002102:Cadaver; D002339:Carotid Arteries / Q000033:anatomy & histology; D001270:Cervical Atlas / Q000033:anatomy & histology / Q000601:surgery; D004210:Dissection / Q000379:methods; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D005064:Eustachian Tube / Q000033:anatomy & histology; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009300:Nasal Septum / Q000033:anatomy & histology / Q000601:surgery; D009305:Nasopharynx / Q000033:anatomy & histology / Q000601:surgery; D009666:Nose / Q000601:surgery; D009777:Occipital Bone / Q000033:anatomy & histology / Q000601:surgery; D009809:Odontoid Process / Q000033:anatomy & histology / Q000601:surgery*; D013101:Sphenoid Sinus / Q000033:anatomy & histology; D014420:Turbinates / Q000033:anatomy & histology