Abstract
Background We reviewed the current literature pertaining to extended endoscopic endonasal approaches
to the craniovertebral junction.
Methods A systematic literature review was utilized to identify published surgical cases
of endoscopic endonasal approaches to the craniovertebral junction. Full-text manuscripts
were examined for various measures of surgical indications, patient characteristics,
operative technique, and surgical outcomes.
Results We identified 71 cases involving endoscopic endonasal approaches for surgical management
of a variety of pathologies located within the craniovertebral junction. Patient ages
ranged from 3 to 87 years, with 40 females and 31 males. Five patients required tracheostomy,
two were reintubated, and all others experienced an average intubation duration of
0.54 days following surgery. Fifty-eight patients (81.7%) underwent an additional
posterior decompression or fusion either before or after the endonasal procedure.
A complete resection of the pathologic lesion was reported in 57 cases (83.8%), another
five were successful biopsies, and four resulted in partial resection. The follow-up
time ranged from 0.5 to 57 months.
Conclusion Although the transoral approach has been the standard for anterior surgical management
for the past several decades, our systematic review illustrates that the extended
endoscopic endonasal approach is a safe and effective alternative for most pathologies
affecting the craniovertebral junction.
Keywords
craniovertebral junction - endoscopic - endonasal - transnasal - transoral - cervicomedullary
- craniocervical - odontoidectomy - basilar invagination
