Combined transnasal and transoral endoscopic approaches to the craniovertebral junction
Objectives: To describe and evaluate a new technique of a combined endoscope-assisted transnasal and transoral approach to decompress the craniovertebral junction. Materials and Methods: A retrospective cohort of patients requiring an anterior decompression at the craniovertebral junction over a 12...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2010-01-01
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| Series: | Journal of Craniovertebral Junction and Spine |
| Subjects: | |
| Online Access: | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2010;volume=1;issue=1;spage=44;epage=48;aulast=El-Sayed |
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| author | I H El-Sayed J-C Wu C P Ames G Balamurali P V Mummaneni |
| author_facet | I H El-Sayed J-C Wu C P Ames G Balamurali P V Mummaneni |
| author_sort | I H El-Sayed |
| collection | DOAJ |
| description | Objectives: To describe and evaluate a new technique of a combined endoscope-assisted transnasal and transoral approach to decompress the craniovertebral junction. Materials and Methods: A retrospective cohort of patients requiring an anterior decompression at the craniovertebral junction over a 12-month period was studied. Eleven patients were identified and included in the study. Eight of the patients had an endoscopic approach [endonasal (2), endooral (2), and combined (4)]. Four of the 8 patients in the endoscopic group had a prior open transoral procedure at other institutions. These 8 patients were compared with a contemporary group of 3 patients who had an open, transoral-transpalatal approach. Charts, radiographic images, and pathologic diagnosis were reviewed. We evaluated the following issues: airway obstruction, dysphagia, velopharyngeal insufficiency (VPI), length of hospital stay (LOS), adequate decompression, and the need for revision surgery. Results: Adequate anterior decompression was achieved in all the patients. The endoscopic cohort had a reduced LOS (P = 0.014), reduced need for prolonged intubation/tracheotomy (P =0.024) and a trend toward reduced VPI (P = 0.061) when compared with the open surgery group. None of the patients required a revision surgery. Conclusion: Proper choice of endoscopic transnasal, transoral, or combined approaches allows anterior decompression at the craniovertebral junction, while avoiding the need to split the palate. A combined transnasal-transoral approach appears to reduce procedure-related morbidity compared with open, transoral, and transpalatal surgeries. |
| first_indexed | 2024-12-13T07:50:53Z |
| format | Article |
| id | doaj.art-a1583ab166654ab7877b9c52cfd1573d |
| institution | Directory Open Access Journal |
| issn | 0974-8237 |
| language | English |
| last_indexed | 2024-12-13T07:50:53Z |
| publishDate | 2010-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Craniovertebral Junction and Spine |
| spelling | doaj.art-a1583ab166654ab7877b9c52cfd1573d2022-12-21T23:54:41ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82372010-01-0111444810.4103/0974-8237.65481Combined transnasal and transoral endoscopic approaches to the craniovertebral junctionI H El-SayedJ-C WuC P AmesG BalamuraliP V MummaneniObjectives: To describe and evaluate a new technique of a combined endoscope-assisted transnasal and transoral approach to decompress the craniovertebral junction. Materials and Methods: A retrospective cohort of patients requiring an anterior decompression at the craniovertebral junction over a 12-month period was studied. Eleven patients were identified and included in the study. Eight of the patients had an endoscopic approach [endonasal (2), endooral (2), and combined (4)]. Four of the 8 patients in the endoscopic group had a prior open transoral procedure at other institutions. These 8 patients were compared with a contemporary group of 3 patients who had an open, transoral-transpalatal approach. Charts, radiographic images, and pathologic diagnosis were reviewed. We evaluated the following issues: airway obstruction, dysphagia, velopharyngeal insufficiency (VPI), length of hospital stay (LOS), adequate decompression, and the need for revision surgery. Results: Adequate anterior decompression was achieved in all the patients. The endoscopic cohort had a reduced LOS (P = 0.014), reduced need for prolonged intubation/tracheotomy (P =0.024) and a trend toward reduced VPI (P = 0.061) when compared with the open surgery group. None of the patients required a revision surgery. Conclusion: Proper choice of endoscopic transnasal, transoral, or combined approaches allows anterior decompression at the craniovertebral junction, while avoiding the need to split the palate. A combined transnasal-transoral approach appears to reduce procedure-related morbidity compared with open, transoral, and transpalatal surgeries.http://www.jcvjs.com/article.asp?issn=0974-8237;year=2010;volume=1;issue=1;spage=44;epage=48;aulast=El-SayedCraniovertebral junctionendonasalendoscopicodontoidectomytransnasaltransoral |
| spellingShingle | I H El-Sayed J-C Wu C P Ames G Balamurali P V Mummaneni Combined transnasal and transoral endoscopic approaches to the craniovertebral junction Journal of Craniovertebral Junction and Spine Craniovertebral junction endonasal endoscopic odontoidectomy transnasal transoral |
| title | Combined transnasal and transoral endoscopic approaches to the craniovertebral junction |
| title_full | Combined transnasal and transoral endoscopic approaches to the craniovertebral junction |
| title_fullStr | Combined transnasal and transoral endoscopic approaches to the craniovertebral junction |
| title_full_unstemmed | Combined transnasal and transoral endoscopic approaches to the craniovertebral junction |
| title_short | Combined transnasal and transoral endoscopic approaches to the craniovertebral junction |
| title_sort | combined transnasal and transoral endoscopic approaches to the craniovertebral junction |
| topic | Craniovertebral junction endonasal endoscopic odontoidectomy transnasal transoral |
| url | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2010;volume=1;issue=1;spage=44;epage=48;aulast=El-Sayed |
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