Transoral and transnasal odontoidectomy complications: A systematic review and meta-analysis

Shriver, Michael F.; Kshettry, Varun R.; Sindwani, Raj; Woodard, Troy; Benzel, Edward C.; Recinos, Pablo F.

doi:10.1016/j.clineuro.2016.07.019

Cited by 101 publications

(63 citation statements)

References 34 publications

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“…Kassam AB, Abla A, Snyderman C, Carrau R, Spiro R: An endoscopic transnasal odontoidectomy to treat cervicomedullary compression with basilar invagination. Neurosurgery 8: 198-204, 2005 without postoperative tracheostomy requirement (54). The requirement for tracheostomy was statistically higher in the transoral group (54).…”

Section: █ Resultsmentioning

confidence: 97%

“…Several authors have compared TOA and EEA (2,47,54,57,64). In a study of head cadavers, Baird et al reported that the distance to CVJ was shorter than that to EEA (5 (40,41,51); this resulted in TOA gaining popularity.…”

Section: █ Resultsmentioning

confidence: 99%

“…Neurosurgery 8: 198-204, 2005 without postoperative tracheostomy requirement (54). The requirement for tracheostomy was statistically higher in the transoral group (54). In addition, an endoscopic TOA has been described for decompression of CVJ lesions (7,18,46,48).…”

Section: █ Resultsmentioning

confidence: 99%

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Endoscopic endonasal approaches to craniovertebral junction pathologies: a single-center experience

Kahiloğulları¹,

Eroğlu²,

Yakar³

et al. 2018

Turkish Neurosurgery

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AIM: To review our experience of using the endoscopic endonasal approach for clivus and odontoid pathologies as well as craniovertebral junction anomalies at our institution. MATERIAL and METHODS: We retrospectively evaluated 41 patients (21 male, 20 female; age range, 2-65 years) who underwent endoscopic endonasal procedures for craniovertebral junction pathologies between 2008 and 2017. RESULTS: Of the 41 patients, 27 had clivus lesions, 7 had odontoid lesions, 6 had basilar invagination, and 1 had rhinorrhea repair. Six patients underwent an additional posterior decompression/fusion either before or after the endonasal procedure. None of the patients required tracheostomy, and cerebrospinal fluid leakage was postoperatively detected in one patient. The patients' mean modified Rankin scale and visual analog scale scores were 3 and 4, respectively. The follow-up period ranged from 12 to 50 months. CONCLUSION: Although the microscopic transoral approach has been considered the gold standard for craniovertebral junction surgical management, endoscopic approaches are feasible, safe, and effective for addressing pathologies in this region, with developing technique and surgical experience.

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Section: █ Resultsmentioning

confidence: 97%

Section: █ Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic endonasal approaches to craniovertebral junction pathologies: a single-center experience

Kahiloğulları¹,

Eroğlu²,

Yakar³

et al. 2018

Turkish Neurosurgery

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“…reported on 14 patients, of whom only 2 had intraoperative leaks, both successfully repaired. Shriver et al . performed a systematic review comparing transoral to endonasal odontoidectomy.…”

Section: Complicationsmentioning

confidence: 99%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

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157

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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“…Трансоральное микрохирургическое удаление патологического процесса краниовертебральной области является традиционным, проверенным многолетним опытом, надежным и широко применяемым в нейрохирургической практике методом, однако более травматичным по сравнению с эндоскопическим эндоназальным, так как при трансоральном доступе на большем протяжении рассекается область ротоглотки, а также мягкое нёбо [17]. Кроме того, наличие тугоподвижности нижнечелюстного сустава в связи с анатомическими особенностями или вследствие сопутствующих заболеваний ведет к уменьшению размеров операционного поля, угла и зоны операционного действия, что ограничивает использование трансорального доступа.…”

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Endoscopic transnasal removal of the pathologically affected areas of the С2 odontoid process

et al. 2019

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Objective. To assess capabilities and advantages of endoscopic transnasal removal of pathological foci in the region of the C2 odontoid process. Material and Methods. The study included 3 patients who underwent endoscopic transnasal removal of the invaginated odontoid process accompanied by simultaneously (2 cases) or previously performed (1 case) occipitospondylodesis. Results. The pathological focus was totally removed in all cases. Postoperative complication occurred in one case-wound liquorrhea with subsequent development of meningitis which required performing plastic surgery of the CSF fistula. At follow-up examination, all patients presented with complete regression of symptoms. Conclusion. Endoscopic transnasal access allows for radical removal of pathological foci of the craniovertebral junction. Endoscopic transnasal approach will not be able to completely replace a transoral one, but it is a reasonable alternative in experienced hands.

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Transoral and transnasal odontoidectomy complications: A systematic review and meta-analysis

Cited by 101 publications

References 34 publications

Endoscopic endonasal approaches to craniovertebral junction pathologies: a single-center experience

Endoscopic endonasal approaches to craniovertebral junction pathologies: a single-center experience

ICAR: endoscopic skull‐base surgery

Endoscopic transnasal removal of the pathologically affected areas of the С2 odontoid process

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