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CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2021; 82(S 01): S6-S7
DOI: 10.1055/s-0040-1705160
Skull Base: Operative Videos

Endoscopic Endonasal Resection of C1–C2 Pannus, a Step-by-Step Surgical and Anatomical Description: 2-Dimensional Operative Video

Mohamed Samy Elhammady
1   Neuroscience Institute, Neurological Surgery Department, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
2   Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Ohio, USA
,
Mohammad Al-Bar
3   Otolaryngology Head and Neck Surgery, King Fahd Hospital
4   Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi Arabia
,
Florian Roser
1   Neuroscience Institute, Neurological Surgery Department, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
2   Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Ohio, USA
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Abstract

Expanded endonasal endoscopic approaches provide access to the entire central skull base and craiocervical junction. The authors present a case of an 81-year-old man who presented with progressive spastic quadriparesis to the point of being wheel-chair bound. Cervical spine computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated multilevel extensive spondylitic changes with a large pannus at the C1–2 junction, severely compressing the spinal cord ([Figs. 1] and [2]). Given the significant anterior spinal cord compression and the patient's substantial weakness, the decision was made to perform an endoscopic endonasal anterior cervical decompression and resection of the pannus followed a posterior cervical fusion. The patient recovered well following surgery with significant improvement of motor function. The preoperative assessment, the step-by-step surgical technique, and the technical nuances are demonstrated and discussed.

The link to the video can be found at: https://youtu.be/HzrZO-0Vol4.

Keywords

craniocervical junction - expanded endoscopic endonasal approach - C1–C2 pannus - craniocervical decompression


Publication History

Received: 25 March 2019

Accepted: 04 January 2020

Article published online:
06 September 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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