Endoscopic Transoral Excision of Odontoid Process in Irreducible Atlantoaxial Dislocation: Our Experience of 34 Patients

Yadav, Yad Ram; Madhariya, Satya Narayan; Parihar, Vijay; Namdev, Hehant; Bhatele, Pushp Raj

doi:10.1055/s-0032-1327441

Cited by 23 publications

(6 citation statements)

References 34 publications

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“…Endoscopic techniques are increasingly being used in spine,[ 208 209 210 ] skull base[ 211 212 213 ] and intracranial pathologies. [ 214 215 216 ] Endoscopic technique can be used alone in TN[ 217 218 ] or as an adjuvant to microscope[ 219 220 221 ] It is a minimally invasive technique,[ 221 222 ] allows better visualization of entire root from pons to ganglion[ 217 222 223 ] including ventral aspect.…”

Section: Endoscopic Vascular Decompressionmentioning

confidence: 99%

Trigeminal neuralgia

Yadav

Pande

et al. 2017

Asian J Neurosurg

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Trigeminal neuralgia (TN) is a sudden, severe, brief, stabbing, and recurrent pain within one or more branches of the trigeminal nerve. Type 1 as intermittent and Type 2 as constant pain represent distinct clinical, pathological, and prognostic entities. Although multiple mechanism involving peripheral pathologies at root (compression or traction), and dysfunctions of brain stem, basal ganglion, and cortical pain modulatory mechanisms could have role, neurovascular conflict is the most accepted theory. Diagnosis is essentially clinically; magnetic resonance imaging is useful to rule out secondary causes, detect pathological changes in affected root and neurovascular compression (NVC). Carbamazepine is the drug of choice; oxcarbazepine, baclofen, lamotrigine, phenytoin, and topiramate are also useful. Multidrug regimens and multidisciplinary approaches are useful in selected patients. Microvascular decompression is surgical treatment of choice in TN resistant to medical management. Patients with significant medical comorbidities, without NVC and multiple sclerosis are generally recommended to undergo gamma knife radiosurgery, percutaneous balloon compression, glycerol rhizotomy, and radiofrequency thermocoagulation procedures. Partial sensory root sectioning is indicated in negative vessel explorations during surgery and large intraneural vein. Endoscopic technique can be used alone for vascular decompression or as an adjuvant to microscope. It allows better visualization of vascular conflict and entire root from pons to ganglion including ventral aspect. The effectiveness and completeness of decompression can be assessed and new vascular conflicts that may be missed by microscope can be identified. It requires less brain retraction.

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Section: Endoscopic Vascular Decompressionmentioning

confidence: 99%

Trigeminal neuralgia

Yadav

Pande

et al. 2017

Asian J Neurosurg

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“…Although more and more neurosurgical operations are being performed due to the advantages of endoscopic approaches,[ 40 41 42 43 44 ] EE procedures may be associated with problems such as control of the hemorrhage, closure of the dural and bony defects, postoperative CSF leak, tension pneumocephalus, and meningitis etc. [ 45 ] The lack of stereoscopic visualization, the constant need for manual control of the endoscope, and steep learning curve are other limitations.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic endonasal trans-sphenoid management of craniopharyngiomas

Yadav

Parihar

et al. 2015

Asian J Neurosurg

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Introduction:Craniopharyngiomas treatment has been challenging because of their anatomical location. The endoscopic endonasal (EE) trans-sphenoidal approach is indicated in sellar, supra sellar, selected intraventricular lesions in adults and children. We are reporting our initial experience of 44 patients managed by EE approach.Materials and Methods:This is a retrospective study of 44 craniopharyngiomas. The goal of surgery was gross-total resection in all cases. All patients underwent pre- and post-operative comprehensive ophthalmological and endocrinological evaluation. Lumbar drain at the start of the operation was used in all cases with tumor larger than 3 cm maximum diameter. Binostril technique vascularized nasoseptal flap and multilayer closure of the dural defect were used. Wide sphenoidotomy, posterior ethmoidectomy, tuberculum selle, and planum removal were performed in all cases. Perioperative antibiotic prophylaxis was used for 72 h.Results:There were 44 patients of age ranging from 8 to 65 (mean: 42) years. Diameter of the tumor varied from 3.1 cm to 6.6 cm (average: 4.3 cm). Visual and pituitary dysfunctions were observed in 44 and 33, respectively, before surgery. Vision improvement, gross-total removal, cerebrospinal fluid (CSF) leak and recurrence were observed in 34, 26, four and six patients, respectively. Average follow-up was 19 months.Conclusion:Endoscopic endonasal trans-sphenoidal approach for craniopharyngioma is safe and effective alternative to transcranial approach in selected patients. Although this technique is associated with effective tumor removal and improved visual outcome, CSF leak, and endocrine dysfunctions remain a major challenge.

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“… 5 diagnosed IAAD when skull traction for 48–72 h, starting with 7%–8% of the patient's body weight, and increasing to as much as 20%, achieved no satisfactory reduction (ADI ≥3 mm in adults and ≥5 mm in children). There are various treatment methods, based on the current diagnostic criteria, including transoral fascia dentata and partial vertebral axis resection, 6 7 trans-oropharyngeal release plus anterior plate fixation, 8 9 10 and anterior cervical release plus posterior fixation. 11 12 13 14 The diagnosis of IAAD is mainly based on preoperative and intraoperative traction results, as well as the physician's experience, with no relatively uniform guidelines for the selection of treatment; therefore, objective criteria for assessing recoverability and guiding treatment are needed.…”

Section: Introductionmentioning

confidence: 99%