Child's Nervous System

, Volume 28, Issue 11, pp 1971–1975

Endoscopic endonasal odontoidectomy in a child with chronic type 3 atlantoaxial rotatory fixation: case report and literature review

  • Akash J. Patel
  • Jerome Boatey
  • James Muns
  • Robert J. Bollo
  • William E. Whitehead
  • Carla M. Giannoni
  • Andrew Jea
Case Report

DOI: 10.1007/s00381-012-1818-5

Cite this article as:
Patel, A.J., Boatey, J., Muns, J. et al. Childs Nerv Syst (2012) 28: 1971. doi:10.1007/s00381-012-1818-5

Abstract

Introduction

Although the transoral transpharyngeal approach has been the standard approach to decompress the odontoid process, it bears some disadvantages including risk of infection, prolonged intubation or tracheostomy, need for nasogastric tube feeding, extended hospitalization, and possible effects of phonation. The endoscopic transnasal approach is a viable alternative, managing to avoid some of the pitfalls of the more accepted transoral transpharyngeal approach. However, there have only been a handful of adult cases and only three pediatric cases.

Case report

We present the case of a 10-year-old girl with a chronic type 3 atlantoaxial rotator fixation and significant spinal cord compression from basilar invagination and a displaced odontoid process. We performed an endoscopic endonasal odontoidectomy prior to posterior occiptocervical fusion on the patient. She was neurologically intact with a well-healed wound at 7-month follow-up.

Keywords

Endonasal endoscopy Odontoidectomy Atlantoaxial rotatory subluxation Atlantoaxial rotatory fixation Pediatric spine 

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Akash J. Patel
    • 1
    • 2
  • Jerome Boatey
    • 1
  • James Muns
    • 1
  • Robert J. Bollo
    • 2
  • William E. Whitehead
    • 2
  • Carla M. Giannoni
    • 3
  • Andrew Jea
    • 1
  1. 1.Neuro-Spine Program, Division of Pediatric Neurosurgery, Department of Neurosurgery, Texas Children’s HospitalBaylor College of MedicineHoustonUSA
  2. 2.Endoscopic Skull Base Program, Division of Pediatric Neurosurgery, Department of Neurosurgery, Texas Children’s HospitalBaylor College of MedicineHoustonUSA
  3. 3.Division of Pediatric Otolaryngology, Department of Otolaryngology, Texas Children’s HospitalBaylor College of MedicineHoustonUSA

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