Atlantoaxial fixation for craniovertebral anomaly associated with absent posterior elements of the axial vertebra: report of 3 cases

This is a report of 3 relatively rare clinical cases in which the absence of posterior elements of the axis was associated with basilar invagination and multiple other craniovertebral junction musculoskeletal and neural abnormalities. Atlantoaxial fixation resulted in remarkable clinical recovery in all 3 cases. C2–3 fixation was not done, and bone decompression was not done. On the basis of their experience, the authors conclude that atlantoaxial fixation is a satisfactory form of surgical treatment in patients having an association of basilar invagination with absent posterior elements of axis.

Transnasal Endoscopic Removal of Malformation of the Odontoid Process in a Patient with Craniovertebral Anomaly

ABSTRACT The endoscopic endonasal approach is emerging as a feasible alternative to the transoral route for the resection of the odontoid process, when the latter produces a compression of the brainstem and cervicomedullary junction. This type of approach has some advantages, such as excellent prevertebral exposure of the craniovertebral junction in patients with small oral cavities and the possibility to avoid the use of mouth retractors. A report of two patients with a diagnosis of craniovertebral anomaly— basilar invagination into foramen magnum, suffering from an extreme posterior tilt of the odontoid process causing severe anterior compression of the cervicomedullary junction, is presented to stress the potential of this technique to the endoscopic rhinologist. Transnasal endoscopic removal of the odontoid process was performed and resolution of the ventral compression was achieved. This report demonstrates that, in selected cases, a multidisciplinary team approach can help our patients. How to cite this article Nagpal T. Transnasal Endoscopic Removal of Malformation of the Odontoid Process in a Patient with Craniovertebral Anomaly. Clin Rhinol An Int J 2013;6(1): 47-50.

Hemifacial Spasm and Craniovertebral Anomaly

ABSTRACT:Two patients with congenital anomaly of the craniovertebral junction causing disabling hemifacial spasm (HFS) are presented. In one patient, complete cessation of the HFS occurred for a period of two years following simple bony decompression of the craniovertebral junction raising unanswered questions as to the exact pathogenesis of HFS. Eventually both patients required microvascular decompression at the root entry zone of the facial nerve.