Sublabial approach for the treatment of symptomatic basilar impression in a patient with Klippel-Feil syndrome
| Autor: | Jean Paul Wolinsky, Ziya L. Gokaslan, Oliver P. Simmons, Ian Suk, Chetan Bettegowda, Mehdi Shajari |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Foramen magnum medicine.medical_specialty Down syndrome Surgical approach Decompression business.industry Dysostosis Klippel–Feil syndrome medicine.disease Neurosurgical Procedures Surgery medicine.anatomical_structure Klippel-Feil Syndrome Platybasia medicine Basilar Impression Humans Occipital nerve stimulation Female Neurology (clinical) business Brain Stem |
| Zdroj: | Neurosurgery. 69(1 Suppl) |
| ISSN: | 1524-4040 |
| Popis: | BACKGROUND: Basilar impression (BI) is an uncommon condition in which there is upward displacement of the elements forming the foramen magnum, causing trans-location of vertebral elements into the brainstem. Most commonly a developmental anomaly, BI is often associated with congenital conditions such as Down syndrome. Symptomatic BI is often difficult to treat surgically secondary to the anatomic variants associated with many of the coinciding congenital syndromes. OBJECTIVE: To present a feasible approach for the treatment of BI. METHODS: We present an alternative surgical approach for the treatment of symptomatic BI in a 37-year-old woman with Klippel-Feil syndrome. Because of the altered anatomy, traditional approaches such as the transoral-transpharyngeal, transmandibular circumglossal, and transcervical endoscopic routes were not feasible. RESULTS: We chose a staged sublabial, transnasal, transpalatal route for the anterior brainstem decompression followed by posterior fixation. The patient tolerated the procedures well and at last follow-up had nearly complete resolution of symptoms. CONCLUSION: The sublabial route is an alternative approach for anterior decompression in patients with symptomatic basilar impression and altered anatomic circumstances such as that caused by Klippel-Feil syndrome. |
| Databáze: | OpenAIRE |
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