{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:32:29Z","timestamp":1783776749288,"version":"3.55.0"},"reference-count":40,"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:sec>\n                    <jats:title>OBJECT<\/jats:title>\n                    <jats:p>The transoral approach is the gold standard for ventral decompression of the brainstem caused by craniovertebral junction (CVJ) pathology. This approach is often associated with significant morbidity, related to swallowing and respiratory complications. The endoscopic endonasal approach was introduced to reduce the rate of these complications. However, the exact role of this approach in the treatment of CVJ pathology is not well defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A comprehensive literature search was performed to identify series of patients with pathology of the CVJ treated via the endoscopie endonasal approach. Data on patient characteristics, indications for treatment, complications, and outcome were obtained and analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Twelve studies involving 72 patients were included. The most common indications for treatment were rheumatoid pannus (38.9%) and basilar invagination (29.2%). Cerebrospinal fluid leak was found in 18% of cases intraoperatively and 4.2% of cases postoperatively. One case of meningitis complicated by sepsis and death represents the procedure-related mortality of 1.4%. Of the patients without preoperative swallowing impairment, 95% returned to oral feeding on the 3rd postoperative day. Ninety-three percent of patients experienced improvement in neurological symptoms after the procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The endonasal endoscopie approach is effective for the treatment of neural compression caused by CVJ pathology. It offers advantages such as lower rates of postoperative dysphagia and respiratory complications when compared with the more traditional transoral approach. However, these 2 approaches should be seen as complementary rather than alternatives. Patient-related factors as well as the surgeon\u2019s expertise must be considered when making treatment decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2015.1.focus14831","type":"journal-article","created":{"date-parts":[[2015,4,1]],"date-time":"2015-04-01T13:05:25Z","timestamp":1427893525000},"page":"E15","source":"Crossref","is-referenced-by-count":42,"title":["Endoscopic endonasal approach for craniovertebral junction pathology: a review of the literature"],"prefix":"10.3171","volume":"38","author":[{"given":"Saul F.","family":"Morales-Valero","sequence":"first","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Serchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, IRCCS Institute of Neurological Sciences, Bellaria Hospital, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Zoli","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, IRCCS Institute of Neurological Sciences, Bellaria Hospital, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Mazzatenta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, IRCCS Institute of Neurological Sciences, Bellaria Hospital, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie J.","family":"Van Gompel","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus14831","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"},{"issue":"3","key":"b2-focus14831","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":"b3-focus14831","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":"b4-focus14831","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":"b5-focus14831","series-title":"Eur Spine J","first-page":"661","article-title":"Endoscopic transnasal resection of the odontoid: case series and clinical course","volume":"20","author":"Gempt","year":"2011"},{"issue":"Suppl 1","key":"b6-focus14831","series-title":"Eur Spine J","first-page":"S55","article-title":"Endoscopic transnasal odontoid resection to decompress the bulbomedullary junction: a reliable anterior minimally invasive technique without posterior fusion","volume":"21","author":"Gladi","year":"2012"},{"key":"b7-focus14831","series-title":"J Neurosurg","first-page":"511","article-title":"The endoscopic endonasal approach to the odontoid and its impact on early extubation and feeding","volume":"122","author":"Goldschlager","year":"2015"},{"key":"b8-focus14831","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":"b9-focus14831","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":"b10-focus14831","series-title":"Skull Base","first-page":"199","article-title":"Endoscopic transnasal approach to the craniocervical junction","volume":"20","author":"Lee","year":"2010"},{"key":"b11-focus14831","series-title":"Spine (Phila Pa 1976)","first-page":"846","article-title":"Endoscopic endonasal odontoidectomy: clinical series","volume":"39","author":"Mazzatenta","year":"2014"},{"key":"b12-focus14831","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"},{"issue":"4","key":"b13-focus14831","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":"b14-focus14831","series-title":"Op Tech Otolaryngol","first-page":"302","article-title":"Endoscopic versus open approaches to the skull base: a comprehensive literature review","volume":"22","author":"Raper","year":"2011"},{"issue":"4","key":"b15-focus14831","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":"b16-focus14831","series-title":"J Neurosurg Spine","first-page":"437","article-title":"Cystic deterioration of the C1-2 articulation: clinical implications and treatment outcomes","volume":"14","author":"Van Gompel","year":"2011"},{"issue":"1 Suppl 1","key":"b17-focus14831","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":"b18-focus14831","series-title":"J Neurol Surg A Cent Eur Neurosurg","first-page":"162","article-title":"Endoscopic transoral excision of odontoid process in irreducible atlantoaxial dislocation: our experience of 34 patients","volume":"74","author":"Yadav","year":"2013"},{"key":"b19-focus14831","series-title":"J Neurosurg Spine","first-page":"929","article-title":"Endoscopic transnasal odontoidectomy without resection of nasal turbinates: clinical outcomes of 13 patients","volume":"21","author":"Yen","year":"2014"},{"key":"b20-focus14831","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"},{"key":"b1-focus14831","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"},{"issue":"3","key":"b2-focus14831","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":"b3-focus14831","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":"b4-focus14831","series-title":"Orthop Traumatol Surg Res","first-page":"775","article-title":"Advantages and limitations of endoscopic endonasal odontoidectomy. 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