Minimally invasive surgery for invaginated CII odontoid process

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Odontoidectomy is indicated for anterior compression of the brainstem by invaginated odontoid process. This procedure can currently be performed via transoral microsurgical and transnasal endoscopic access.

OBJECTIVE

To analyze the results of endoscopic transnasal odontoidectomy.

MATERIAL AND METHODS

We assessed treatment outcomes in 10 patients with anterior compression of the brainstem by invaginated odontoid process. All patients underwent endoscopic transnasal odontoidectomy.

RESULTS

Brainstem decompression was achieved in all cases.

CONCLUSION

Currently, endoscopic transnasal approach is gradually replacing the transoral one in some patients requiring anterior odontoidectomy. Analysis of literature data reflects the development of this technique taking into account various features of surgical treatment including optimization of dimensions of surgical field, attempts to perform C1-sparing surgeries and analysis of sufficient size of trepanation. Nasopalatine and nasoclival lines are used to select optimal access. Nevertheless, the choice of access depends on equipment of the hospital and surgical experience in most cases.

Keywords:

odontoid process

odontoidectomy

basilar impression

Authors:

Shkarubo A.N.

Burdenko Neurosurgical Center

ORCID: 0000-0003-3445-3115

Chernov I.V.

Burdenko Neurosurgical Center

ORCID: 0000-0002-9789-3452

Andreev D.N.

Burdenko Neurosurgical Center

ORCID: 0000-0001-5473-4905

Konovalov N.A.

Burdenko Neurosurgical Center

ORCID: 0000-0003-0824-1848

Sinelnikov M.E.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0002-0862-6011

Received:

18.01.2023

Accepted:

24.03.2023

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