Endoscopic transnasal decompression for management of basilar invagination in osteogenesis imperfecta

Abstract

<jats:p>Osteogenesis imperfecta (OI) is a disorder of bone development caused by a genetic dysfunction of collagen synthesis. Basilar invagination (BI) is an uncommon but serious complication of OI. Brainstem decompression in OI is undertaken in certain circumstances. Transoral-transpalatopharyngeal ventral decompression with posterior occipitocervical fusion has become the treatment of choice when required. This technical note outlines a novel endoscopic transnasal approach for ventral decompression. The literature is reviewed and a strategy for the management of BI in patients with OI is outlined.</jats:p>

Endoscopic transnasal odontoidectomy without resection of nasal turbinates: clinical outcomes of 13 patients

“…11,12,17,18,26,30,31 There also have been reports about using ETO in pediatric and elderly patients. 12,19,28 Unlike the technique used in these other published cases, which uniformly involved a U-shaped mucosal flap, we used a linear vertical mucosal incision in the nasopharynx.…”

“…1,24 In the past several years, there also have been case reports of ETO published by several authors worldwide. 3,7,11,12,17,18,28,30,31,37,39,40 However, reports on a series of consecutive patients who underwent ETO and long-term follow-up, including data on radiological and clinical outcomes and complications, are still scarce.The present study is, to date, the largest series reported on purely endoscopic transnasal resection of the odontoid process. The aim of this article is to describe the evolution of our surgical techniques for ETO and the outcomes in our series of patients.…”

Evolution from microscopic transoral to endoscopic endonasal odontoidectomy

“…Serious complications documented in previous case reports and clinical series 3,[9][10][11][12]14,16,17,25,26,30,31,34 are infrequent. However, maintaining the integrity of the dura mater is crucial.…”

“…Previous studies 3,[9][10][11][12]14,16,17,22,25,26,30,31,34 have demonstrated the effectiveness and feasibility of an odontoidectomy performed using an EEA and suggest the possibility of less invasiveness than with the oral or cervical approaches. In our small series there is no evidence of different neurological functional outcomes between the techniques.…”

“…1,22 In 2005, Kassam et al 14 documented an expanded endoscopic endonasal approach (EEA), which has since been used, modified, and reported by several authors. 9,11,12,[16][17][18]34,36 We present our experience with craniocervical pathological entities that required posterior instrumentation and odontoidectomy. Endoscopic endonasal odontoidectomy (EEO) and transoral microscopic odontoidectomy (TMO) are described, analyzed, and compared.…”