Nagpal Tapan
Department of Otolaryngology, Skull Base Surgery Division, Smt. Bhikiben Kanjibhai Shah Medical Institute & Research Centre, Pipariya, Waghodia, Vadodara, Gujarat, India.
Kulak Burun Bogaz Ihtis Derg. 2013 Mar-Apr;23(2):123-6. doi: 10.5606/kbbihtisas.2013.80958.
The endoscopic endonasal approach is emerging as a feasible alternative to the transoral route for the resection of the odontoid process, when the latter produces a compression of the brainstem and cervicomedullary junction. This type of approach has some advantages, such as excellent prevertebral exposure of the craniovertebral junction in patients with small oral cavities and the possibility to avoid the use of mouth retractors. In this article, we present a typical case of a 12-year-old female patient with a diagnosis of craniovertebral anomaly-basilar invagination into foramen magnum, suffering from an extreme posterior tilt of the odontoid process causing severe anterior compression of the cervicomedullary junction, is presented to stress the potential of this technique. Transnasal endoscopic removal of the odontoid process was performed and resolution of the ventral compression was achieved. This article demonstrates that in selected cases, a multidisciplinary team approach can help our patients.
当经口入路切除齿状突导致脑干和颈髓交界处受压时，鼻内镜经鼻入路正逐渐成为一种可行的替代方法。这种入路方式具有一些优势，比如对于口腔较小的患者，能很好地暴露颅颈交界区的椎体前方，并且有可能避免使用口腔牵开器。在本文中，我们展示了一名12岁女性患者的典型病例，该患者诊断为颅颈畸形——基底陷入枕骨大孔，齿状突极度向后倾斜，导致颈髓交界处严重向前受压，以此强调该技术的潜力。通过经鼻内镜切除了齿状突，实现了腹侧压迫的解除。本文表明，在特定病例中，多学科团队方法能够帮助我们的患者。
