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CASE REPORT
Year : 2018  |  Volume : 13  |  Issue : 4  |  Page : 1179-1181

Endoscopic endonasal resection of the odontoid process in a patient with chronic injury of the C1 transverse ligament


Department of Neurosurgery, Sklifosovsky Research Institute of Emergency Care, Moscow, Russia

Correspondence Address:
Dr. Ivan Lvov
B. Suharevskaya Pl., 3, Moscow 107945
Russia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajns.AJNS_366_16

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Atlas dislocation after transverse ligament injury is one of the most rare types of trauma to the upper cervical level. If magnetic resonance imaging of the craniovertebral junction reveals the Kassam line passing through the cervix of the odontoid process, a transnasal approach can be used for surgical treatment. Here, we present a case in which an endoscopic endonasal approach was used to treat chronic traumatic transligamentous atlas dislocation. A 26-year-old male underwent two-stage surgical treatment; during the first stage, posterior decompression and fixation were performed under halo immobilization. In the second stage, a transnasal endoscopic approach to the odontoid process was used. A transnasal approach permitted complete decompression of the medulla oblongata and facilitated early extubation of the patient without any postoperative complications such as respiratory or pharyngopalatine deficiency. The patient was discharged in good condition 9 days after the surgery.


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