Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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The endoscopic transnasal approach to the lesions of the craniocervical junction: two case reports

  • Baraa Dabboucy (Department of Neurosurgery, Faculty of Medicine, Lebanese University) ;
  • Wissem Lahiani (Department of Neurosurgery, AP-HP, Henri Mondor Hospital) ;
  • Damien Bresson (Department of Neurosurgery, AP-HP, Henri Mondor Hospital) ;
  • Nouman Aldahak (Department of Neurosurgery, AP-HP, Henri Mondor Hospital)
  • Received : 2022.03.31
  • Accepted : 2022.06.22
  • Published : 2023.01.31
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Abstract

The endoscopic endonasal approach (EEA) to the craniovertebral junction (CVJ) has recently been considered a safer alternative and less invasive approach than the traditional transoral approach because the complications associated with the latter are avoided or minimized. Here, we present two challenging cases of CVJ pathologies. The first case involved os odontoideum associated with anterior displacement of the occipitocervical junction where the EEA was used, followed by C0-C1-C2 fusion using a posterior approach to decompress the CVJ, and was complicated by rhinorrhea and Candida albicans meningitis. The second case involved basilar invagination with syringomyelia previously treated using a posterior approach, where aggravation of neuropathic symptoms required combined treatment with EEA and occipitocervical fusion of C0-C2-C3-C4, with the postoperative course challenged by operative site infection requiring drainage with debridement and antibiotic therapy. The EEA is an alternative approach for accessing the CVJ in well-selected patients. Knowledge of EEA complications is crucial for the optimal care of patients.

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References

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