Endoscopic Endonasal Transclival Odontoidectomy for Basilar Invagination: Operative Video and Technical Nuances

James K. Liu; Vincent N. Dodson; Kevin Zhao; Jean Anderson Eloy

doi:10.1055/s-0040-1715522

Journal of Neurological Surgery Part B: Skull Base, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2021; 82(S 01): S16-S18
DOI: 10.1055/s-0040-1715522

Skull Base: Operative Videos

Endoscopic Endonasal Transclival Odontoidectomy for Basilar Invagination: Operative Video and Technical Nuances

James K. Liu

¹Department of Neurological Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, Robert Wood Johnson Barnabas Health, Newark, New Jersey, United States

²Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Newark, New Jersey, United States

³Center for Skull Base and Pituitary Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Newark, New Jersey, United States

,

Vincent N. Dodson

¹Department of Neurological Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, Robert Wood Johnson Barnabas Health, Newark, New Jersey, United States

,

Kevin Zhao

¹Department of Neurological Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, Robert Wood Johnson Barnabas Health, Newark, New Jersey, United States

³Center for Skull Base and Pituitary Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Newark, New Jersey, United States

,

Jean Anderson Eloy

¹Department of Neurological Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, Robert Wood Johnson Barnabas Health, Newark, New Jersey, United States

²Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Newark, New Jersey, United States

³Center for Skull Base and Pituitary Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Newark, New Jersey, United States

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Keywords

endoscopic endonasal approach - transclival odontoidectomy - endoscopic skull base surgery - basilar invagination - craniovertebral junction - operative video

Fig. 1 Top left: Preoperative T2 weighted sagittal MRI demonstrating severe basilar invagination with the odontoid process compressing the cervicomedullary junction and narrowing of the foramen magnum. Bottom left: Preoperative CT sagittal demonstrating the anterior arch of C1 assimilated to the foramen magnum and the C3 and C4 vertebral bodies were fused consistent with Klippel–Feil syndrome. Right: Intraoperative photograph showing endoscopic drilling of the odontoid process using eggshell technique. CT, computed tomography; MRI, magnetic resonance imaging.

Fig. 2 (A and B) Preoperative T2-weighted sagittal MRI (A) and sagittal CT (B) demonstrating severe basilar invagination with the odontoid process compressing the cervicomedullary junction and narrowing of the foramen magnum. (C and D) Postoperative T2-weighted sagittal MRI (C) and sagittal CT (D) demonstrating excellent decompression of the cervicomedullary junction and occipitocervical instrumented stabilization. CT, computed tomography; MRI, magnetic resonance imaging.

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Fig. 1 Top left: Preoperative T2 weighted sagittal MRI demonstrating severe basilar invagination with the odontoid process compressing the cervicomedullary junction and narrowing of the foramen magnum. Bottom left: Preoperative CT sagittal demonstrating the anterior arch of C1 assimilated to the foramen magnum and the C3 and C4 vertebral bodies were fused consistent with Klippel–Feil syndrome. Right: Intraoperative photograph showing endoscopic drilling of the odontoid process using eggshell technique. CT, computed tomography; MRI, magnetic resonance imaging.

Fig. 2 (A and B) Preoperative T2-weighted sagittal MRI (A) and sagittal CT (B) demonstrating severe basilar invagination with the odontoid process compressing the cervicomedullary junction and narrowing of the foramen magnum. (C and D) Postoperative T2-weighted sagittal MRI (C) and sagittal CT (D) demonstrating excellent decompression of the cervicomedullary junction and occipitocervical instrumented stabilization. CT, computed tomography; MRI, magnetic resonance imaging.