Endoscopic endonasal approaches to the craniovertebral junction: The Otolaryngologist's perspective

Objective: To review indications and techniques for the endoscopic endonasal approach to the craniovertebral junction (CVJ), analyze postoperative outcomes, and discuss important technical considerations. Methods: A retrospective analysis was performed on all patients undergoing endonasal endoscopic...

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Autores principales:	Qasim Husain, Matthew H. Kim, Ibrahim Hussain, Vijay K. Anand, Jeffrey P. Greenfield, Theodore H. Schwartz, Ashutosh Kacker
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2020
Materias:	Odontoidectomy Craniovertebral junction Endoscopic skull base surgery Otorhinolaryngology RF1-547 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/5def13a3601a4df68c1e8771239147cc
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spelling	oai:doaj.org-article:5def13a3601a4df68c1e8771239147cc2021-12-02T13:38:37ZEndoscopic endonasal approaches to the craniovertebral junction: The Otolaryngologist's perspective2095-881110.1016/j.wjorl.2020.01.001https://doaj.org/article/5def13a3601a4df68c1e8771239147cc2020-06-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095881120300160https://doaj.org/toc/2095-8811Objective: To review indications and techniques for the endoscopic endonasal approach to the craniovertebral junction (CVJ), analyze postoperative outcomes, and discuss important technical considerations. Methods: A retrospective analysis was performed on all patients undergoing endonasal endoscopic approaches to the CVJ from May 2007 to June 2017. Demographic information, presenting symptoms, imaging results, treatment course, postoperative functional status, and follow-up were recorded. Results: There was a total of 30 patients in this series, with a mean follow-up of 11.7 months. The average age was 33.6 years (range, 5–75 years), with 18 females and 12 males. The majority of patients (n = 22, 73.3%) had Chiari malformation type 1 with basilar invagination and symptomatic cervicomedullary compression as the indication for surgery. Intraoperative cerebrospinal fluid leak (CSF) was noted in 3 cases of odontoid resection and a single case of skull base resection. There were no postoperative CSF leaks. Overall, 81% of patients resumed regular diet by post-operative day 2 (range, 0–8 days). Severe postoperative dysphagia occurred in two cases with one requiring gastrostomy tube placement and another utilizing total parenteral nutrition for support prior to eventual gastrostomy. On average, patients were extubated by postoperative day 0.93 (range 0–3 days), with 85% extubated by postoperative day 1. A tracheotomy was required in one patient. Conclusion: The endonasal endoscopic approach is a valuable technique for access to the CVJ with minimal disruption of respiratory and alimentary function.Qasim HusainMatthew H. KimIbrahim HussainVijay K. AnandJeffrey P. GreenfieldTheodore H. SchwartzAshutosh KackerKeAi Communications Co., Ltd.articleOdontoidectomyCraniovertebral junctionEndoscopic skull base surgeryOtorhinolaryngologyRF1-547SurgeryRD1-811ENWorld Journal of Otorhinolaryngology-Head and Neck Surgery, Vol 6, Iss 2, Pp 94-99 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Odontoidectomy Craniovertebral junction Endoscopic skull base surgery Otorhinolaryngology RF1-547 Surgery RD1-811
spellingShingle	Odontoidectomy Craniovertebral junction Endoscopic skull base surgery Otorhinolaryngology RF1-547 Surgery RD1-811 Qasim Husain Matthew H. Kim Ibrahim Hussain Vijay K. Anand Jeffrey P. Greenfield Theodore H. Schwartz Ashutosh Kacker Endoscopic endonasal approaches to the craniovertebral junction: The Otolaryngologist's perspective
description	Objective: To review indications and techniques for the endoscopic endonasal approach to the craniovertebral junction (CVJ), analyze postoperative outcomes, and discuss important technical considerations. Methods: A retrospective analysis was performed on all patients undergoing endonasal endoscopic approaches to the CVJ from May 2007 to June 2017. Demographic information, presenting symptoms, imaging results, treatment course, postoperative functional status, and follow-up were recorded. Results: There was a total of 30 patients in this series, with a mean follow-up of 11.7 months. The average age was 33.6 years (range, 5–75 years), with 18 females and 12 males. The majority of patients (n = 22, 73.3%) had Chiari malformation type 1 with basilar invagination and symptomatic cervicomedullary compression as the indication for surgery. Intraoperative cerebrospinal fluid leak (CSF) was noted in 3 cases of odontoid resection and a single case of skull base resection. There were no postoperative CSF leaks. Overall, 81% of patients resumed regular diet by post-operative day 2 (range, 0–8 days). Severe postoperative dysphagia occurred in two cases with one requiring gastrostomy tube placement and another utilizing total parenteral nutrition for support prior to eventual gastrostomy. On average, patients were extubated by postoperative day 0.93 (range 0–3 days), with 85% extubated by postoperative day 1. A tracheotomy was required in one patient. Conclusion: The endonasal endoscopic approach is a valuable technique for access to the CVJ with minimal disruption of respiratory and alimentary function.
format	article
author	Qasim Husain Matthew H. Kim Ibrahim Hussain Vijay K. Anand Jeffrey P. Greenfield Theodore H. Schwartz Ashutosh Kacker
author_facet	Qasim Husain Matthew H. Kim Ibrahim Hussain Vijay K. Anand Jeffrey P. Greenfield Theodore H. Schwartz Ashutosh Kacker
author_sort	Qasim Husain
title	Endoscopic endonasal approaches to the craniovertebral junction: The Otolaryngologist's perspective
title_short	Endoscopic endonasal approaches to the craniovertebral junction: The Otolaryngologist's perspective
title_full	Endoscopic endonasal approaches to the craniovertebral junction: The Otolaryngologist's perspective
title_fullStr	Endoscopic endonasal approaches to the craniovertebral junction: The Otolaryngologist's perspective
title_full_unstemmed	Endoscopic endonasal approaches to the craniovertebral junction: The Otolaryngologist's perspective
title_sort	endoscopic endonasal approaches to the craniovertebral junction: the otolaryngologist's perspective
publisher	KeAi Communications Co., Ltd.
publishDate	2020
url	https://doaj.org/article/5def13a3601a4df68c1e8771239147cc
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Endoscopic endonasal approaches to the craniovertebral junction: The Otolaryngologist's perspective

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