Endoscopic transnasal resection of the odontoid in a patient with severe brainstem compression.

摘要

Different approaches that allow access to the odontoid process have been described over the years. In case of persistent symptomatic space occupation only, resection of the odontoid is necessary to decompress the brainstem after posterior spinal decompression and fusion [1, 2]. The transoral (endoscopic or non-endoscopic) approach evolved to be the most commonly used. Complications associated with this approach are velopharyngeal incompetence, hypernasal speech, swallowing disturbances, and temporo-mandibular joint syndrome [6, 7]. The endoscopic trans-nasal approach for resection of the odontoid process has been introduced recently and experience is limited to few groups so far [4, 5].