Odontoidectomy
Endoscopic SkullBase Surgery
Odontoidectomy
Basilar invagination is an uncommon condition that occurs when the upper portion of the second vertebra (C2) moves upward. This may cause compression of the spinal cord and brainstem, creating a variety of neurological problems, including sudden death. This condition may be present at birth; may occur as the result of an accident; or may occur in patients with bone diseases such as rheumatoid arthritis.
Patients may have headache, dizziness, confusion, swallowing problems, numbness/tingling in the extremities and paralysis. Symptoms can become worse with flexion of the head, which causes further drapes the brainstem and/or spinal cord by the odontoid process.
Basilar invagination can be diagnosed by imaging studies such as head X-rays, CT and MRI scans.
Non-surgical treatment for basilar invagination that is not compressing the spinal cord may include physical therapy, non-steroidal anti-inflammatory medication, or a cervical collar.
Traditionally, odontoidectomy has been done through the mouth after splitting the soft palate. Traversing the oral cavity increases the risk of infection. To prevent this oral feeding is withheld for a week after surgery. Splitting the soft palate can cause nasal regurgitation and can affect phonation.
Most patients will subsequently need posterior cranio-cervical fusion to prevent recurrence and to stabilize the joints.
If surgery is needed, the odontoid and clivus can be approached through the nose using an endoscope to decompress the brainstem and spinal cord.
The Heart Of Clinic
Dr. C. Rayappa MBBS, DLO, FRCS(Edin)
SENIOR CONSULTANT
+91 44 3315 1105
Dr. C. Rayappa graduated from Madras Medical College, Chennai, India in 1982. He completed his post graduation in Otolaryngology (ENT)
The Heart Of Clinic
Dr. C. Rayappa MBBS, DLO, FRCS(Edin)
SENIOR CONSULTANT
+91 44 3315 1105
Dr. C. Rayappa graduated from Madras Medical College, Chennai, India in 1982. He completed his post graduation in Otolaryngology (ENT)