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J Neurol Surg B Skull Base 2015; 76(06): 480-488
DOI: 10.1055/s-0035-1554904
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Endonasal Approaches to the Craniovertebral Junction: A Systematic Review of the Literature

Tatsuhiro Fujii
1   Department of Neurosurgery, Keck School of Medicine of USC, Los Angeles, California, United States
,
Andrew Platt
1   Department of Neurosurgery, Keck School of Medicine of USC, Los Angeles, California, United States
,
Gabriel Zada
1   Department of Neurosurgery, Keck School of Medicine of USC, Los Angeles, California, United States
› Institutsangaben
Weitere Informationen

Publikationsverlauf

03. Januar 2015

11. März 2015

Publikationsdatum:
19. Juni 2015 (online)

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Abstract

Background We reviewed the current literature pertaining to extended endoscopic endonasal approaches to the craniovertebral junction.

Methods A systematic literature review was utilized to identify published surgical cases of endoscopic endonasal approaches to the craniovertebral junction. Full-text manuscripts were examined for various measures of surgical indications, patient characteristics, operative technique, and surgical outcomes.

Results We identified 71 cases involving endoscopic endonasal approaches for surgical management of a variety of pathologies located within the craniovertebral junction. Patient ages ranged from 3 to 87 years, with 40 females and 31 males. Five patients required tracheostomy, two were reintubated, and all others experienced an average intubation duration of 0.54 days following surgery. Fifty-eight patients (81.7%) underwent an additional posterior decompression or fusion either before or after the endonasal procedure. A complete resection of the pathologic lesion was reported in 57 cases (83.8%), another five were successful biopsies, and four resulted in partial resection. The follow-up time ranged from 0.5 to 57 months.

Conclusion Although the transoral approach has been the standard for anterior surgical management for the past several decades, our systematic review illustrates that the extended endoscopic endonasal approach is a safe and effective alternative for most pathologies affecting the craniovertebral junction.

Keywords

craniovertebral junction - endoscopic - endonasal - transnasal - transoral - cervicomedullary - craniocervical - odontoidectomy - basilar invagination
 

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