University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Department of Neurological Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Acta Neurochir (Wien). 2023 Oct;165(10):2979-2983. doi: 10.1007/s00701-023-05708-1. Epub 2023 Jul 19.
We describe a patient with symptomatic os odontoideum and a previous history of C1-2 wiring who underwent successful treatment with a staged endonasal odontoidectomy and C1-2 revision of instrumentation. Access to the odontoid process was gained through the endonasal corridor using an inverted U-shaped nasopharyngeal flap (IUNF). Post-operatively, the patient experienced resolution of her presenting neurologic symptoms but developed conductive hearing loss secondary to bilateral middle ear effusion, requiring bilateral myringotomy and tube placement 3 months post-operatively. We hypothesize this dysfunction may have resulted from surgical edema, packing buttressing the IUNF, or some combination thereof. In this manuscript, we review the evolution of the nasopharyngeal exposure for odontoidectomy and whether an IUNF may predispose to this complication.
我们描述了一位有症状的寰椎齿状突过长和 C1-2 布线病史的患者，她成功地接受了分期经鼻寰椎切除术和 C1-2 器械翻修治疗。通过使用倒 U 形鼻咽瓣（IUNF）经鼻内通道进入齿状突。术后，患者的神经症状得到缓解，但因双侧中耳积液导致传导性听力损失，术后 3 个月行双侧鼓膜切开和置管。我们假设这种功能障碍可能是由于手术水肿、IUNF 支撑所致，或两者兼有。在本手稿中，我们回顾了经鼻暴露用于齿状突切除术的演变，以及 IUNF 是否可能导致这种并发症。
