{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:17:29Z","timestamp":1790281049298,"version":"4.1.0"},"reference-count":106,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:p>The transoral approach is considered the gold-standard surgical route for performing anterior odontoidectomy and ventral decompression of the craniovertebral junction for pathological conditions that result in symptomatic cervicomedullary compression, including basilar invagination, rheumatoid pannus, platybasia with retroflexed odontoid processes, and neoplasms. Extended modifications to increase the operative corridor and exposure include the transmaxillary, extended \u201copen-door\u201d maxillotomy, transpalatal, and transmandibular approaches. With the advent of extended endoscopic endonasal skull base techniques, there has been increased interest in the last decade in the endoscopic endonasal transclival transodontoid approach to the craniovertebral junction. The endonasal route represents an attractive minimally invasive surgical alternative, especially in cases of irreducible basilar invagination in which the pathology is situated well above the palatine line. Angled endoscopes and instrumentation can also be used for lower-lying pathology. By avoiding the oral cavity and subsequently using a transoral retractor, the endonasal route has the advantages of avoiding complications related to tongue swelling, tracheal swelling, prolonged intubation, velopharyngeal insufficiency, dysphagia, and dysphonia. Postoperative recovery is quicker, and hospital stays are shorter. In this report, the authors describe and illustrate their method of purely endoscopic endonasal transclival odonotoidectomy for anterior decompression of the craniovertebral junction and describe various operative pearls and nuances of the technique for avoiding complications.<\/jats:p>","DOI":"10.3171\/2015.1.focus14813","type":"journal-article","created":{"date-parts":[[2015,4,1]],"date-time":"2015-04-01T13:05:25Z","timestamp":1427893525000},"page":"E17","source":"Crossref","is-referenced-by-count":58,"title":["Endoscopic endonasal transclival transodontoid approach for ventral decompression of the craniovertebral junction: operative technique and nuances"],"prefix":"10.3171","volume":"38","author":[{"given":"James K.","family":"Liu","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Otolaryngology-Head and Neck Surgery,"},{"name":"Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy","family":"Patel","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ira M.","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Anderson","family":"Eloy","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"Otolaryngology-Head and Neck Surgery,"},{"name":"Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2 Suppl Operative","key":"b1-focus14813","series-title":"Neurosurgery","first-page":"ons308","article-title":"The naso-axial line: a new method of accurately predicting the inferior limit of the endoscopic endonasal approach to the craniovertebral junction","volume":"71","author":"Aldana","year":"2012"},{"key":"b2-focus14813","series-title":"Acta Neurochir (Wien)","first-page":"219","article-title":"Endoscopic endonasal approach to the ventral craniocervical junction: anatomical study","volume":"144","author":"Alfieri","year":"2002"},{"key":"b3-focus14813","series-title":"Neurosurgery","first-page":"201","article-title":"Transoral exposure of the atlantoaxial region","volume":"3","author":"Apuzzo","year":"1978"},{"issue":"6 Suppl","key":"b4-focus14813","series-title":"Neurosurgery","first-page":"158","article-title":"Radiographic and anatomic basis of endoscopic anterior craniocervical decompression: a comparison of endonasal, transoral, and transcervical approaches","volume":"65","author":"Baird","year":"2009"},{"key":"b5-focus14813","series-title":"Neurosurgery","first-page":"296","article-title":"Evolution of transoral surgery: three decades of change in patients, pathologies, and indications","volume":"73","author":"Choi","year":"2013"},{"issue":"3","key":"b6-focus14813","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Experience with intraoperative navigation and imaging during endoscopic transnasal spinal approaches to the foramen magnum and odontoid","volume":"36","author":"Choudhri","year":"2014"},{"key":"b7-focus14813","series-title":"Ann R Coll Surg Engl","first-page":"321","article-title":"The transoral approach to the base of the brain and upper cervical cord","volume":"67","author":"Crockard","year":"1985"},{"key":"b8-focus14813","series-title":"Br J Neurosurg","first-page":"283","article-title":"Transoral surgery: some lessons learned","volume":"9","author":"Crockard","year":"1995"},{"key":"b9-focus14813","series-title":"J Bone Joint Surg Br","first-page":"682","article-title":"One-stage transoral decompression and posterior fixation in rheumatoid atlantoaxial subluxation","volume":"72","author":"Crockard","year":"1990"},{"key":"b10-focus14813","series-title":"J Bone Joint Surg Br","first-page":"350","article-title":"Transoral decompression and posterior fusion for rheumatoid atlanto-axial subluxation","volume":"68","author":"Crockard","year":"1986"},{"key":"b11-focus14813","series-title":"Neurosurgery","first-page":"351","article-title":"Endoscopic image-guided transcervical odontoidectomy: outcomes of 15 patients with basilar invagination","volume":"70","author":"Dasenbrock","year":"2012"},{"key":"b12-focus14813","series-title":"Laryngoscope","first-page":"239","article-title":"Defining the nasopalatine line: the limit for endonasal surgery of the spine","volume":"119","author":"de Almeida","year":"2009"},{"key":"b13-focus14813","series-title":"J Clin Neurosci","first-page":"1726","article-title":"Resolution of cervical syringomyelia after transoral odontoidectomy and occipitocervical fusion in a patient with basilar invagination and Type I Chiari malformation","volume":"19","author":"Dickman","year":"2012"},{"key":"b14-focus14813","series-title":"Orthop Traumatol Surg Res","first-page":"775","article-title":"Advantages and limitations of endoscopic endonasal odontoidectomy. A series of nine cases","volume":"100","author":"Duntze","year":"2014"},{"key":"b15-focus14813","series-title":"World Neurosurg","first-page":"183","article-title":"The importance of platybasia and the palatine line in patient selection for endonasal surgery of the craniocervical junction: a radiographic study of 12 patients","volume":"76","author":"El-Sayed","year":"2011"},{"key":"b16-focus14813","series-title":"J Neurosurg Spine","first-page":"281","article-title":"Treatment of basilar invagination by atlantoaxial joint distraction and direct lateral mass fixation","volume":"1","author":"Goel","year":"2004"},{"key":"b17-focus14813","series-title":"J Neurosurg","first-page":"962","article-title":"Basilar invagination: a study based on 190 surgically treated patients","volume":"88","author":"Goel","year":"1998"},{"key":"b18-focus14813","series-title":"J Neurosurg Spine","first-page":"281","article-title":"The endoscopic endonasal approach to the odontoid and its impact on early extubation and feeding","volume":"1","author":"Goldschlager","year":"2014"},{"key":"b19-focus14813","series-title":"Laryngoscope","first-page":"1882","article-title":"A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap","volume":"116","author":"Hadad","year":"2006"},{"key":"b20-focus14813","series-title":"J Neurosurg","first-page":"16","article-title":"The transoral approach to the superior cervical spine. A review of 53 cases of extradural cervicomedullary compression","volume":"71","author":"Hadley","year":"1989"},{"key":"b21-focus14813","series-title":"J Neurosurg Pediatr","first-page":"549","article-title":"Transnasal odontoid resection followed by posterior decompression and occipitocervical fusion in children with Chiari malformation Type I and ventral brainstem compression","volume":"5","author":"Hankinson","year":"2010"},{"key":"b22-focus14813","series-title":"J Neurosurg Spine","first-page":"354","article-title":"Endoscopic transnasal decompression for management of basilar invagination in osteogenesis imperfecta","volume":"9","author":"Hansen","year":"2008"},{"key":"b23-focus14813","series-title":"Spine J","first-page":"542","article-title":"Endoscopic endonasal odontoidectomy with anterior C1 arch preservation in elderly patients affected by rheumatoid arthritis","volume":"13","author":"Iacoangeli","year":"2013"},{"key":"b24-focus14813","series-title":"Neurosurgery","first-page":"E213","article-title":"The expanded endonasal approach: a fully endoscopic transnasal approach and resection of the odontoid process: technical case report","volume":"57","author":"Kassam","year":"2005"},{"key":"b25-focus14813","series-title":"Neurosurgery","first-page":"ONS44","article-title":"Endoscopic reconstruction of the cranial base using a pedicled nasoseptal flap","volume":"63","author":"Kassam","year":"2008"},{"key":"b26-focus14813","series-title":"Eur Spine J","first-page":"1656","article-title":"Treatment of basilar invagination","volume":"23","author":"Klekamp","year":"2014"},{"key":"b27-focus14813","series-title":"J Clin Neurosci","first-page":"565","article-title":"Odontoid compression of the brainstem without basilar impression\u2014 \u201codontoid invagination.\u201d","volume":"12","author":"Kyoshima","year":"2005"},{"key":"b28-focus14813","series-title":"J Neurosurg Spine","first-page":"376","article-title":"Endonasal endoscopic resection of the odontoid process in a nonachondroplastic dwarf with juvenile rheumatoid arthritis: feasibility of the approach and utility of the intraoperative Iso-C three-dimensional navigation. Case report","volume":"8","author":"Laufer","year":"2008"},{"key":"b29-focus14813","series-title":"Spine (Phila Pa 1976)","first-page":"E139","article-title":"Endonasal endoscopic resection of an os odontoideum to decompress the cervicomedullary junction: a minimal access surgical technique","volume":"34","author":"Leng","year":"2009"},{"key":"b30-focus14813","series-title":"Skull Base","first-page":"151","article-title":"Transoral approach and extended modifications for lesions of the ventral foramen magnum and craniovertebral junction","volume":"18","author":"Liu","year":"2008"},{"issue":"6","key":"b31-focus14813","series-title":"Neurosurg Focus","first-page":"E7","article-title":"Surgical nuances for nasoseptal flap reconstruction of cranial base defects with high-flow cerebrospinal fluid leaks after endoscopic skull base surgery","volume":"32","author":"Liu","year":"2012"},{"key":"b32-focus14813","series-title":"Neurosurgery","first-page":"E373","article-title":"Endoscopic endonasal odontoidectomy in a patient affected by Down syndrome: technical case report","volume":"63","author":"Magrini","year":"2008"},{"key":"b33-focus14813","series-title":"Spine (Phila Pa 1976)","first-page":"846","article-title":"Endoscopic endonasal odontoidectomy: clinical series","volume":"39","author":"Mazzatenta","year":"2014"},{"key":"b34-focus14813","series-title":"J Neurosurg Pediatr","first-page":"337","article-title":"Endoscopic transcervical odontoidectomy for pediatric basilar invagination and cranial settling. Report of 4 cases","volume":"1","author":"McGirt","year":"2008"},{"key":"b35-focus14813","series-title":"Childs Nerv Syst","first-page":"1187","article-title":"Surgical approaches: postoperative care and complications \u201ctransoral-transpalatopharyngeal approach to the craniocervical junction.\u201d","volume":"24","author":"Menezes","year":"2008"},{"key":"b36-focus14813","series-title":"J Neurosurg","first-page":"895","article-title":"Transoral-transpharyngeal approach to the anterior craniocervical junction. Ten-year experience with 72 patients","volume":"69","author":"Menezes","year":"1988"},{"key":"b37-focus14813","series-title":"J Neurosurg","first-page":"500","article-title":"Odontoid upward migration in rheumatoid arthritis. An analysis of 45 patients with \u201ccranial settling.\u201d","volume":"63","author":"Menezes","year":"1985"},{"key":"b38-focus14813","series-title":"Neurosurg Rev","first-page":"189","article-title":"Pure endoscopic endonasal odontoidectomy: anatomical study","volume":"30","author":"Messina","year":"2007"},{"key":"b39-focus14813","series-title":"Neurosurgery","first-page":"1045","article-title":"Transoral odontoidectomy","volume":"56","author":"Mummaneni","year":"2005"},{"key":"b40-focus14813","series-title":"Am J Rhinol","first-page":"601","article-title":"Experience with the expanded endonasal approach for resection of the odontoid process in rheumatoid disease","volume":"21","author":"Nayak","year":"2007"},{"key":"b41-focus14813","series-title":"Childs Nerv Syst","first-page":"1971","article-title":"Endoscopic endonasal odontoidectomy in a child with chronic type 3 atlantoaxial rotatory fixation: case report and literature review","volume":"28","author":"Patel","year":"2012"},{"issue":"5 Suppl 2","key":"b42-focus14813","series-title":"Neurosurgery","first-page":"437","article-title":"Endoscopic image-guided transoral approach to the craniovertebral junction: an anatomic study comparing surgical exposure and surgical freedom obtained with the endoscope and the operating microscope","volume":"64","author":"Pillai","year":"2009"},{"issue":"4","key":"b43-focus14813","series-title":"Neurosurg Focus","first-page":"E15","article-title":"Evolution from microscopic transoral to endoscopic endonasal odontoidectomy","volume":"37","author":"Ponce-G\u00f3mez","year":"2014"},{"key":"b44-focus14813","series-title":"Spine (Phila Pa 1976)","first-page":"E901","article-title":"Transoral endoscopic odontoidectomy to decompress the cervicomedullary junction","volume":"38","author":"Qiuhang","year":"2013"},{"key":"b45-focus14813","series-title":"Laryngoscope","first-page":"584","article-title":"Endonasal odontoidectomy for basilar impression and brainstem compression due to radiation fibrosis","volume":"123","author":"Rawal","year":"2013"},{"key":"b46-focus14813","series-title":"J Neurol Surg B Skull Base","first-page":"176","article-title":"Endonasal access to the upper cervical spine, part one: radiographic morphometric analysis","volume":"74","author":"Singh","year":"2013"},{"key":"b47-focus14813","series-title":"Acta Neurochir Suppl (Wien)","first-page":"69","article-title":"The transoral approach to the anterior superior cervical spine. A review of 29 cases","volume":"43","author":"Spetzler","year":"1988"},{"key":"b48-focus14813","series-title":"J Craniofac Surg","first-page":"1482","article-title":"The selective odontoidectomy: endoscopic endonasal approach to the craniocervical junction","volume":"25","author":"Tanriverdi","year":"2014"},{"issue":"4","key":"b49-focus14813","series-title":"Neurosurg Focus","first-page":"E16","article-title":"Transnasal odontoid resection: is there an anatomic explanation for differing swallowing outcomes?","volume":"37","author":"Van Abel","year":"2014"},{"key":"b50-focus14813","series-title":"J Neurosurg Spine","first-page":"184","article-title":"Endoscopic image-guided odontoidectomy for decompression of basilar invagination via a standard anterior cervical approach. Technical note","volume":"6","author":"Wolinsky","year":"2007"},{"key":"b51-focus14813","series-title":"Neurosurgery","first-page":"ONSE92","article-title":"Endoscopic transnasal transclival odontoidectomy: a new approach to decompression: technical case report","volume":"63","author":"Wu","year":"2008"},{"key":"b52-focus14813","series-title":"J Neurosurg Spine","first-page":"637","article-title":"Endoscopic transnasal odontoidectomy combined with posterior reduction to treat basilar invagination. Technical note","volume":"19","author":"Yu","year":"2013"},{"key":"b53-focus14813","series-title":"Eur Spine J","first-page":"1127","article-title":"Endoscopic transnasal odontoidectomy to treat basilar invagination with congenital osseous malformations","volume":"22","author":"Yu","year":"2013"},{"issue":"2 Suppl Operative","key":"b1-focus14813","series-title":"Neurosurgery","first-page":"ons308","article-title":"The naso-axial line: a new method of accurately predicting the inferior limit of the endoscopic endonasal approach to the craniovertebral junction","volume":"71","author":"Aldana","year":"2012"},{"key":"b2-focus14813","series-title":"Acta Neurochir (Wien)","first-page":"219","article-title":"Endoscopic endonasal approach to the ventral craniocervical junction: anatomical study","volume":"144","author":"Alfieri","year":"2002"},{"key":"b3-focus14813","series-title":"Neurosurgery","first-page":"201","article-title":"Transoral exposure of the atlantoaxial region","volume":"3","author":"Apuzzo","year":"1978"},{"issue":"6 Suppl","key":"b4-focus14813","series-title":"Neurosurgery","first-page":"158","article-title":"Radiographic and anatomic basis of endoscopic anterior craniocervical decompression: a comparison of endonasal, transoral, and transcervical approaches","volume":"65","author":"Baird","year":"2009"},{"key":"b5-focus14813","series-title":"Neurosurgery","first-page":"296","article-title":"Evolution of transoral surgery: three decades of change in patients, pathologies, and indications","volume":"73","author":"Choi","year":"2013"},{"issue":"3","key":"b6-focus14813","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Experience with intraoperative navigation and imaging during endoscopic transnasal spinal approaches to the foramen magnum and odontoid","volume":"36","author":"Choudhri","year":"2014"},{"key":"b7-focus14813","series-title":"Ann R Coll Surg Engl","first-page":"321","article-title":"The transoral approach to the base of the brain and upper cervical cord","volume":"67","author":"Crockard","year":"1985"},{"key":"b8-focus14813","series-title":"Br J Neurosurg","first-page":"283","article-title":"Transoral surgery: some lessons learned","volume":"9","author":"Crockard","year":"1995"},{"key":"b9-focus14813","series-title":"J Bone Joint Surg Br","first-page":"682","article-title":"One-stage transoral decompression and posterior fixation in rheumatoid atlantoaxial subluxation","volume":"72","author":"Crockard","year":"1990"},{"key":"b10-focus14813","series-title":"J Bone Joint Surg Br","first-page":"350","article-title":"Transoral decompression and posterior fusion for rheumatoid atlanto-axial subluxation","volume":"68","author":"Crockard","year":"1986"},{"key":"b11-focus14813","series-title":"Neurosurgery","first-page":"351","article-title":"Endoscopic image-guided transcervical odontoidectomy: outcomes of 15 patients with basilar invagination","volume":"70","author":"Dasenbrock","year":"2012"},{"key":"b12-focus14813","series-title":"Laryngoscope","first-page":"239","article-title":"Defining the nasopalatine line: the limit for endonasal surgery of the spine","volume":"119","author":"de Almeida","year":"2009"},{"key":"b13-focus14813","series-title":"J Clin Neurosci","first-page":"1726","article-title":"Resolution of cervical syringomyelia after transoral odontoidectomy and occipitocervical fusion in a patient with basilar invagination and Type I Chiari malformation","volume":"19","author":"Dickman","year":"2012"},{"key":"b14-focus14813","series-title":"Orthop Traumatol Surg Res","first-page":"775","article-title":"Advantages and limitations of endoscopic endonasal odontoidectomy. A series of nine cases","volume":"100","author":"Duntze","year":"2014"},{"key":"b15-focus14813","series-title":"World Neurosurg","first-page":"183","article-title":"The importance of platybasia and the palatine line in patient selection for endonasal surgery of the craniocervical junction: a radiographic study of 12 patients","volume":"76","author":"El-Sayed","year":"2011"},{"key":"b16-focus14813","series-title":"J Neurosurg Spine","first-page":"281","article-title":"Treatment of basilar invagination by atlantoaxial joint distraction and direct lateral mass fixation","volume":"1","author":"Goel","year":"2004"},{"key":"b17-focus14813","series-title":"J Neurosurg","first-page":"962","article-title":"Basilar invagination: a study based on 190 surgically treated patients","volume":"88","author":"Goel","year":"1998"},{"key":"b18-focus14813","series-title":"J Neurosurg Spine","first-page":"281","article-title":"The endoscopic endonasal approach to the odontoid and its impact on early extubation and feeding","volume":"1","author":"Goldschlager","year":"2014"},{"key":"b19-focus14813","series-title":"Laryngoscope","first-page":"1882","article-title":"A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap","volume":"116","author":"Hadad","year":"2006"},{"key":"b20-focus14813","series-title":"J Neurosurg","first-page":"16","article-title":"The transoral approach to the superior cervical spine. A review of 53 cases of extradural cervicomedullary compression","volume":"71","author":"Hadley","year":"1989"},{"key":"b21-focus14813","series-title":"J Neurosurg Pediatr","first-page":"549","article-title":"Transnasal odontoid resection followed by posterior decompression and occipitocervical fusion in children with Chiari malformation Type I and ventral brainstem compression","volume":"5","author":"Hankinson","year":"2010"},{"key":"b22-focus14813","series-title":"J Neurosurg Spine","first-page":"354","article-title":"Endoscopic transnasal decompression for management of basilar invagination in osteogenesis imperfecta","volume":"9","author":"Hansen","year":"2008"},{"key":"b23-focus14813","series-title":"Spine J","first-page":"542","article-title":"Endoscopic endonasal odontoidectomy with anterior C1 arch preservation in elderly patients affected by rheumatoid arthritis","volume":"13","author":"Iacoangeli","year":"2013"},{"key":"b24-focus14813","series-title":"Neurosurgery","first-page":"E213","article-title":"The expanded endonasal approach: a fully endoscopic transnasal approach and resection of the odontoid process: technical case report","volume":"57","author":"Kassam","year":"2005"},{"key":"b25-focus14813","series-title":"Neurosurgery","first-page":"ONS44","article-title":"Endoscopic reconstruction of the cranial base using a pedicled nasoseptal flap","volume":"63","author":"Kassam","year":"2008"},{"key":"b26-focus14813","series-title":"Eur Spine J","first-page":"1656","article-title":"Treatment of basilar invagination","volume":"23","author":"Klekamp","year":"2014"},{"key":"b27-focus14813","series-title":"J Clin Neurosci","first-page":"565","article-title":"Odontoid compression of the brainstem without basilar impression\u2014 \u201codontoid invagination.\u201d","volume":"12","author":"Kyoshima","year":"2005"},{"key":"b28-focus14813","series-title":"J Neurosurg Spine","first-page":"376","article-title":"Endonasal endoscopic resection of the odontoid process in a nonachondroplastic dwarf with juvenile rheumatoid arthritis: feasibility of the approach and utility of the intraoperative Iso-C three-dimensional navigation. Case report","volume":"8","author":"Laufer","year":"2008"},{"key":"b29-focus14813","series-title":"Spine (Phila Pa 1976)","first-page":"E139","article-title":"Endonasal endoscopic resection of an os odontoideum to decompress the cervicomedullary junction: a minimal access surgical technique","volume":"34","author":"Leng","year":"2009"},{"key":"b30-focus14813","series-title":"Skull Base","first-page":"151","article-title":"Transoral approach and extended modifications for lesions of the ventral foramen magnum and craniovertebral junction","volume":"18","author":"Liu","year":"2008"},{"issue":"6","key":"b31-focus14813","series-title":"Neurosurg Focus","first-page":"E7","article-title":"Surgical nuances for nasoseptal flap reconstruction of cranial base defects with high-flow cerebrospinal fluid leaks after endoscopic skull base surgery","volume":"32","author":"Liu","year":"2012"},{"key":"b32-focus14813","series-title":"Neurosurgery","first-page":"E373","article-title":"Endoscopic endonasal odontoidectomy in a patient affected by Down syndrome: technical case report","volume":"63","author":"Magrini","year":"2008"},{"key":"b33-focus14813","series-title":"Spine (Phila Pa 1976)","first-page":"846","article-title":"Endoscopic endonasal odontoidectomy: clinical series","volume":"39","author":"Mazzatenta","year":"2014"},{"key":"b34-focus14813","series-title":"J Neurosurg Pediatr","first-page":"337","article-title":"Endoscopic transcervical odontoidectomy for pediatric basilar invagination and cranial settling. Report of 4 cases","volume":"1","author":"McGirt","year":"2008"},{"key":"b35-focus14813","series-title":"Childs Nerv Syst","first-page":"1187","article-title":"Surgical approaches: postoperative care and complications \u201ctransoral-transpalatopharyngeal approach to the craniocervical junction.\u201d","volume":"24","author":"Menezes","year":"2008"},{"key":"b36-focus14813","series-title":"J Neurosurg","first-page":"895","article-title":"Transoral-transpharyngeal approach to the anterior craniocervical junction. Ten-year experience with 72 patients","volume":"69","author":"Menezes","year":"1988"},{"key":"b37-focus14813","series-title":"J Neurosurg","first-page":"500","article-title":"Odontoid upward migration in rheumatoid arthritis. An analysis of 45 patients with \u201ccranial settling.\u201d","volume":"63","author":"Menezes","year":"1985"},{"key":"b38-focus14813","series-title":"Neurosurg Rev","first-page":"189","article-title":"Pure endoscopic endonasal odontoidectomy: anatomical study","volume":"30","author":"Messina","year":"2007"},{"key":"b39-focus14813","series-title":"Neurosurgery","first-page":"1045","article-title":"Transoral odontoidectomy","volume":"56","author":"Mummaneni","year":"2005"},{"key":"b40-focus14813","series-title":"Am J Rhinol","first-page":"601","article-title":"Experience with the expanded endonasal approach for resection of the odontoid process in rheumatoid disease","volume":"21","author":"Nayak","year":"2007"},{"key":"b41-focus14813","series-title":"Childs Nerv Syst","first-page":"1971","article-title":"Endoscopic endonasal odontoidectomy in a child with chronic type 3 atlantoaxial rotatory fixation: case report and literature review","volume":"28","author":"Patel","year":"2012"},{"issue":"5 Suppl 2","key":"b42-focus14813","series-title":"Neurosurgery","first-page":"437","article-title":"Endoscopic image-guided transoral approach to the craniovertebral junction: an anatomic study comparing surgical exposure and surgical freedom obtained with the endoscope and the operating microscope","volume":"64","author":"Pillai","year":"2009"},{"issue":"4","key":"b43-focus14813","series-title":"Neurosurg Focus","first-page":"E15","article-title":"Evolution from microscopic transoral to endoscopic endonasal odontoidectomy","volume":"37","author":"Ponce-G\u00f3mez","year":"2014"},{"key":"b44-focus14813","series-title":"Spine (Phila Pa 1976)","first-page":"E901","article-title":"Transoral endoscopic odontoidectomy to decompress the cervicomedullary junction","volume":"38","author":"Qiuhang","year":"2013"},{"key":"b45-focus14813","series-title":"Laryngoscope","first-page":"584","article-title":"Endonasal odontoidectomy for basilar impression and brainstem compression due to radiation fibrosis","volume":"123","author":"Rawal","year":"2013"},{"key":"b46-focus14813","series-title":"J Neurol Surg B Skull Base","first-page":"176","article-title":"Endonasal access to the upper cervical spine, part one: radiographic morphometric analysis","volume":"74","author":"Singh","year":"2013"},{"key":"b47-focus14813","series-title":"Acta Neurochir Suppl (Wien)","first-page":"69","article-title":"The transoral approach to the anterior superior cervical spine. 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