{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T22:37:08Z","timestamp":1720737428057},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"S 01","license":[{"start":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:00:00Z","timestamp":1584662400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003Transoral odontoidectomy in the treatment of basilar invagination is surgically challenging. Incision of the soft palate significantly increases rostral exposure of the clivus but is associated with a high incidence of speech and swallowing difficulties after surgery. We present a patient suffering from severe compression of the medulla oblongata due to an extreme form of basilar invagination treated successfully with the resection of dens via a transoral nasopharyngeal approach without palatotomy.<\/jats:p><jats:p>\n          Setting\u2003Microsurgical endoscopic-assisted odontoidectomy through a transoral epipharyngeal approach was performed with subsequent craniocervical stabilization in a 21-year-old patient suffering from progressive myelopathy due to compression of the medulla oblongata and associated progressive syringomyelia.<\/jats:p><jats:p>\n          Results\u2003The 21-year-old man was initially treated with suboccipital craniotomy and duroplasty in another institution. After initial improval he subsequently developed progressive ataxia, dysphagia, a bulbar speech, and weakness of the extremities. Beside ventral compression, he developed a secondary Chiari's malformation and a holospinal syringomyelia. Resection of the dens was successfully accomplished via a microsurgical transoral epipharyngeal endoscopic-controlled odontoidectomy without palatotomy. One week after odontoidectomy, posterior craniocervical stabilization was performed. All preoperative symptoms and signs improved significantly and the patient leads an independent life 4 years after odontoidectomy. On follow-up magnetic resonance imaging (MRI), the syringomyelia completely resolved.<\/jats:p><jats:p>\n          Conclusions\u2003Palatotomy with its potential adverse effects can usually be avoided even for the treatment of extreme forms of basilar invagination.<\/jats:p><jats:p>The link to the video can be found at: https:\/\/youtu.be\/CBKE4n94W4g.<\/jats:p>","DOI":"10.1055\/s-0040-1701216","type":"journal-article","created":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T21:10:37Z","timestamp":1585689037000},"page":"S4-S5","source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Basilar Invagination: Transoral Microsurgical Endoscopically-Controlled Odontoidectomy without Palatotomy in Extreme form of Basilar Invagination"],"prefix":"10.1055","volume":"82","author":[{"given":"Hischam","family":"Bassiouni","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Klinikum Amberg and Klinikum Weiden, Bavaria, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,3,20]]},"container-title":["Journal of Neurological Surgery Part B: Skull Base"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1701216.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T11:40:39Z","timestamp":1615203639000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1701216"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,20]]},"references-count":0,"journal-issue":{"issue":"S 01","published-online":{"date-parts":[[2021,3,5]]},"published-print":{"date-parts":[[2021,2]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1701216","relation":{},"ISSN":["2193-6331","2193-634X"],"issn-type":[{"value":"2193-6331","type":"print"},{"value":"2193-634X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,20]]}}}