Endoscopic Endonasal Odontoidectomy for Basilar Invagination―Technical Note―

Background : Basilar invagination (BI) is a condition where the odontoid process of the axis protrudes into the cranial cavity, compressing the brainstem, and leading to neurological symptoms. Surgical intervention is necessary for patients with significant neurological deficits. Although various approaches, including anterior decompression and posterior fixation, are used for treatment, the choice of approach remains controversial. Traditionally, transoral approaches have been performed for anterior decompression ; however, these can cause significant morbidities owing to the need for facial and oral incisions. Recent advancements in endoscopic techniques have enabled the development of endoscopic endonasal odontoidectomy, a less invasive alternative. This study details the techniques and outcomes of the BI approach.