Display options
Cite
Zenga F, Marengo N, Pacca P, et al. C1 anterior arch preservation in transnasal odontoidectomy using three-dimensional endoscope: A case report. Surg Neurol Int. 2015;6:192doi: 10.4103/2152-7806.172696.
Zenga, F., Marengo, N., Pacca, P., Pecorari, G., & Ducati, A. (2015). C1 anterior arch preservation in transnasal odontoidectomy using three-dimensional endoscope: A case report. Surgical neurology international, 6192. https://doi.org/10.4103/2152-7806.172696
Zenga, Francesco, et al. "C1 anterior arch preservation in transnasal odontoidectomy using three-dimensional endoscope: A case report." Surgical neurology international vol. 6 (2015): 192. doi: https://doi.org/10.4103/2152-7806.172696
Zenga F, Marengo N, Pacca P, Pecorari G, Ducati A. C1 anterior arch preservation in transnasal odontoidectomy using three-dimensional endoscope: A case report. Surg Neurol Int. 2015 Dec 28;6:192. doi: 10.4103/2152-7806.172696. eCollection 2015. PMID: 26759737; PMCID: PMC4697203.
Copy Download .nbib Format: NLM
Share it on

Surg Neurol Int. 2015 Dec 28;6:192. doi: 10.4103/2152-7806.172696. eCollection 2015.

C1 anterior arch preservation in transnasal odontoidectomy using three-dimensional endoscope: A case report.

Surgical neurology international

Francesco Zenga, Nicola Marengo, Paolo Pacca, Giancarlo Pecorari, Alessandro Ducati

Affiliations

  1. Department of Neurosciences, Molinette University Hospital, Via Cherasco 15, 10126 Torino, Italy.
  2. Department of Surgical Sciences, First ENT Division, Molinette University Hospital, Via Genova 3, 10126 Torino, Italy.

PMID: 26759737 PMCID: PMC4697203 DOI: 10.4103/2152-7806.172696

Abstract

BACKGROUND: The transoral ventral corridor is the most common approach used to reach the craniovertebral junction (CVJ). Over the last decade, many case reports have demonstrated the transnasal corridor to the odontoid peg represents a practicable route to remove the tip of the odontoid process. The biomechanical consequences of the traditional odontoidectomy led to the necessity of a cervical spine stabilization. Preserving the inferior portion of the C1 anterior arch should prevent instability.

CASE DESCRIPTION: This is the first report in which the technique to remove the tip of the odontoid while preserving the C1 anterior arch is described by means of a three-dimensional (3D) endoscope. A 53-year-old man underwent a transnasal 3D endoscopic approach because of a complex CVJ malformation. The upper-medial portion of the C1 anterior arch was removed preserving its continuity, and the odontoidectomy was performed. After surgery, a dynamic X-ray scan showed no difference in CVJ motility in comparison with the preoperative one.

CONCLUSIONS: The stereoscopic perception augmented the precision of the surgical gesture in the deep field. The importance of a 3D view relates to the depth of field, which a two-dimensional endoscopy cannot provide. This affects the preservation of the C1 anterior arch because of the presence of critical structures that are exposed to potential damage if not displayed.

Keywords: C1 anterior arch preservation; craniovertebral junction stability; three-dimensional endoscope; transnasal odontoidectomy

References

  1. Neurosurg Focus. 1999 Jun 15;6(6):e7 - PubMed
  2. Am J Surg. 1993 Oct;166(4):336-40 - PubMed
  3. Br J Neurosurg. 1995;9(3):283-93 - PubMed
  4. Neurosurgery. 2010 Mar;66(3 Suppl Operative):E118; discussion E118 - PubMed
  5. Neurosurg Focus. 2005 Jul 15;19(1):E2 - PubMed
  6. Spine J. 2013 May;13(5):542-8 - PubMed
  7. Acta Neurochir (Wien). 2012 Oct;154(10):1825-6 - PubMed
  8. Am J Rhinol. 2007 Sep-Oct;21(5):601-6 - PubMed
  9. Otolaryngol Head Neck Surg. 1995 Oct;113(4):393-400 - PubMed
  10. Spine (Phila Pa 1976). 2009 Feb 15;34(4):E139-43 - PubMed
  11. J Spinal Disord. 1992 Dec;5(4):383-9; discussion 397 - PubMed
  12. Eur Spine J. 2009 Jun;18(6):869-76 - PubMed
  13. Neurosurgery. 2005 Jul;57(1 Suppl):E213; discussion E213 - PubMed
  14. Neurol India. 2013 Jan-Feb;61(1):69-72 - PubMed
  15. Neurosurgery. 2011 Mar;68(1 Suppl Operative):103-113; discussion 113 - PubMed
  16. Neurosurgery. 2012 Feb;70(2):351-9; discussion 359-60 - PubMed
  17. Eur Spine J. 2010 Aug;19(8):1288-98 - PubMed
  18. Neurosurgery. 2010 Mar;66(3 Suppl):7-12 - PubMed
  19. Acta Otorhinolaryngol Ital. 2012 Jun;32(3):189-91 - PubMed
  20. Neurosurg Rev. 2007 Jul;30(3):189-94; discussion 194 - PubMed
  21. Neurosurgery. 2008 Aug;63(2):E373-4; discussion E374 - PubMed
  22. Neurosurgery. 1995 Jun;36(6):1146-52; discussion 1152-3 - PubMed
  23. Eur Spine J. 2012 May;21 Suppl 1:S55-60 - PubMed
  24. Childs Nerv Syst. 2007 Jun;23(6):665-71 - PubMed
  25. J Anaesthesiol Clin Pharmacol. 2013 Apr;29(2):200-4 - PubMed
  26. Neurosurgery. 2009 Dec;65(6):1116-28; discussion 1128-30 - PubMed
  27. Ann R Coll Surg Engl. 1985 Sep;67(5):321-5 - PubMed
  28. Spine (Phila Pa 1976). 2012 May 20;37(12):1030-5 - PubMed
  29. Spine (Phila Pa 1976). 2000 Jul 1;25(13):1607-16 - PubMed
  30. Neurosurgery. 2005 May;56(5):1045-50; discussion 1045-50 - PubMed
  31. J Bone Joint Surg Am. 1974 Dec;56(8):1683-91 - PubMed
  32. J Bone Joint Surg Am. 1970 Apr;52(3):543-9 - PubMed
  33. J Neurosurg Spine. 2007 Feb;6(2):184-91 - PubMed
  34. Arq Neuropsiquiatr. 2007 Dec;65(4B):1166-71 - PubMed
  35. J Neurosurg Pediatr. 2008 Apr;1(4):337-42 - PubMed
  36. J Neurosci Nurs. 1986 Apr;18(2):57-62 - PubMed
  37. Acta Neurochir (Wien). 2002 Mar;144(3):219-25; discussion 225 - PubMed

Publication Types