Evolution from microscopic transoral to endoscopic endonasal odontoidectomy. In addition, pure odontoidectomy without posterior fixation cannot correct the swanneck deformity and accelerates degeneration of the subaxial cervical spine. These pictures showing an intraoperative view of a hybrid operating room with an artis pheno advanced medical imaging device during endoscopic endonasal odontoidectomy a in collaboration with a navigation system b. From july 2007 to june 2010, 5 patients 3 males and 2 females, age range, 2541 yr with irreducible cervicomedullary junction. A standard transoral odontoidectomy exposure was performed. The use of heftier screws in the occipital condyles reduces the need for 45 inches of clunky hardware attached to thin bone and instead is a 1. The procedure was completed with posterior decompression c1 laminectomy and stabilisation wire fusion, not recorded. Pdf endoscopic transoral excision of odontoid process in.
C1c2 arthrodesis after transoral odontoidectomy and. Due to inconsistent reporting, statistical significance was only achieved for postoperative tracheostomy, which was significantly higher in the transoral group. Asymptomatic acdf nonunions underestimate the true prevalence of. Introduction da vinci transoral surgery tors is perhaps the most effective minimally invasive surgical treatment for diseases of the head and neck available today. Odontoidectomy may be considered one of the most complicated manoeuvres for the transoral approach, in which the split of the soft and even hard palate is often necessary.
Clinically, a large proportion of these patients require fusion after transoral odontoidectomy 1, 4, 7, 18. Transoral odontoidectomy followed by occipitocervical fixation is a widely\ud used approach to relieve ventral compressions at the craniovertebral junction cvj. Odontoidectomy is a standard procedure employed in the treatment of irreducible, compressive ventral pathologies of the craniovertebral junction cvj. Nevertheless, over the last decade, many cadaver studies and case reports2 6 7 17 18 30 demonstrated the transnasal corridor to the odontoid peg is a practicable route. Endoscopic transnasal transclival resection of the odontoid process is less invasive than the standard transoral odontoidectomy. Advantages and limitations of endoscopic endonasal.
Patients were positioned in 3point fixation using mayfield pins in slight extension. Transoral odontoidectomy and c12 posterior fusion complication. From july 2007 to june 2010, 5 patients 3 males and 2 females, age range, 2541 yr with irreducible cervicomedullary junction compression were subjected. An intraoral camera allows our practice to view clear, precise images of your teeth and gums. Development of a transoral robotic surgery program in canada. Video cervical facet fractures and dislocations presented by michael y. C1 anterior arch preservation in transnasal odontoidectomy using. The endoscopic transoral approach to the craniovertebral. Viewing 5 reply threads author posts june 15, 2009 at 5. Oral surgery videos pittsburgh pa, informational videos. Please click on the image to begin, and choose a specific video of interest.
The transoral ventral corridor is the most common approach used to reach the craniovertebral junction cvj. Odontoidectomy can help decompress ventral compression of the. The procedure was completed with posterior decompression c1 laminectomy and stabilisation wire. The endoscopic transnasal odontoidectomy is a feasible and effective method in the treatment of irreducible ventral cervicomedullary junction compression, which has several advantages over the transoral approach. These pathologies can be approached through either a high retropharyngeal approach or a transoral approach. Apuzzo ml, weiss mh, heiden js 1978 transoral exposure of the atlantoaxial region. Oral surgery videos midtown nyc, dental implant video, tmj video. Mar 25, 2016 neurosurgeons and ent surgeons at henry ford hospital team up to perform a transoral odontoidectomy followed by posterior occipito thoracic fixation in a patient with cervical myelopathy and. Technique of transoral odontoidectomy springerlink. The surface dimensions of the atlas vertebra and the transoral approach for odontoidectomy have been described in detail.
An anatomical study for evaluation of anterior c1c2. Pdf complications of transoral and transnasal odontoidectomy. The development of endoscopic procedures has made it possible to perform odontoidectomy via a minimally invasive endoscopic endonasal approach. Many common questions pertaining to wisdom tooth extraction are discussed. Contemporary transoral surgery for primary head and neck. Definition of odontectomy in the medical dictionary by the free dictionary. Complications of transoral and transnasal odontoidectomy. The patient made a remarkable recovery in the immediate postoperative period, with motor recovery to his. However, the endonasal approach has a much longer working distance compared with the transoral approach to the craniovertebral junction and usually the endonasal approach needs a previous occipitocervical posterior fusion. Evolution of transoral approaches, endoscopic endonasal. Autoplay when autoplay is enabled, a suggested video. Endoscopic transnasal odontoidectomy using ultrasonic bone. Transoral approach for odontoidectomy efficacy and safety. Transoral endoscopic odontoidectomy to decompress the cervic.
Video depicting the endoscopic transoral odontoidectomy. Thus, this approach could be evaluated for those cases in which a transoral removal is considered more difficult. Our approach to anterior odontoid resection through transoral. The transoral approach to the craniovertebral junction is an excellent surgical technique for treating ventral midline extradural compressive pathology. Online videos for king of prussia pa oral surgeon wohar. The endoscopic transnasal odontoidectomy is emerging as a feasible surgical alternative to conventional microscopic transoral approach. The transoral approach with microscopic assistance has been the standard procedure to perform an odontoidectomy, in accordance with the etiology of the disease, the mechanism of compression, and whether the bone could or could not be reduced. The transoral and transnasal routes have been described for anterior decompression surgery. Traditionally, transoral or transnasal odontoidectomy has been used to treat iaad. The video clip illustrates the surgical steps for the patient of c12 subluxation and received transnasal odontoidectomy and transoral mucosal suture. This is intraoral system by dynamic abutment solutions on vimeo, the home for high quality videos and the people who love them.
Specifically, we outline the steps that were necessary to obtain institutional and multidisciplinary team. However, this approach is associated with high complication rates involving swallowing and. Transoral odontoidectomy neurosurgery oxford academic. The endoscopic excision of the odontoid process in irreducible atlantoaxial dislocation aad can be achieved by transnasal, transoral, and transcervical approaches. In 2005, kassam reported a technical case describing the. The longus colli muscles flank the dens on each side and, more laterally, the longus capitis muscles. Jul 16, 2008 after oral intubation, the odontoidectomy was performed first. Ventral compression due to craniovertebral junction cvj anomalies has been traditionally accessed through a transoral approach. He then underwent a transoral odontoidectomy which was complicated by durotomy. Sonntag, md the transoral approach to the craniovertebral junction is an excellent surgical technique for treating ventral midline extradural compressive pathological conditions. Technical notes on the endoscopic endonasal approach to the. Anterior arcus of c1 must be drilled out to reach odontoid process for transoral odontoidectomy. Overview transoral carbon dioxide laser surgery for primary. Transoral robotic surgery vs transoral laser microsurgery for.
Transoral robotic surgery tors for base tongue neoplasms. In this study, we used in vitro biomechanical testing for a quantitative and qualitative analysis of the biomechanical effects of transoral odontoidectomy. After a month of ventilator support, the patient underwent transoral odontoidectomy and ventral decompression of the cord. Additionally, posterior surgeries are difficult to perform on patients. Endoscopic transoral odontoidectomy bentham science. Transoral robotic sleep apnea torsa surgery utilizes the same approach to open the upper airway of patients with obstructive sleep apnea. C1 anterior arch preservation in transnasal odontoidectomy. Intraoral camera taly dental implant specialists of san diego. Endoscopic transnasal odontoidectomy to treat basilar. The transoral route has been used for many years as the standard approach to decompress the ventral craniovertebral junction cvj. Camera recommendations for dentistry surgery videos.
Technique of transoral odontoidectomy sciencedirect. Due to significant differences in healthcare structure between the united states and canada, there are unique barriers to adopting new medical technology in canada. Odontocare is a member of vimeo, the home for high quality videos and the people who love them. The patients halo was repositioned, and he underwent a posterior occipitalcervical instrumentation. Functional outcomes after transoral robotic surgery for head and neck cancer. Our approach to anterior odontoid resection through transoral approach for. Carrau, md the odontoid process is located in a critical area of the spine and is part of a complex structure, the aflantoaxial junction. Assisted by endoscopy, yu et al 38 and others have performed transnasal odontoidectomy to treat bi. To provide essential anatomic data for safer transoral odontoidectomy.
Odontectomy definition of odontectomy by medical dictionary. Informed consent videos chicago oral surgery videos. The fukuyama japan border crossword clue buchan caves public holidays mancation 2014 toyota coach cecile 2 flat teutonia spirit s3 kinderwagen joolz fabricio werdum vs mark hunt weigh. Neurosurgeons and ent surgeons at henry ford hospital team up to perform a transoral odontoidectomy followed by posterior occipito thoracic fixation in a patient with cervical myelopathy and. Manual, anterior open, posterior open spinal injuries. Halo traction was initially pursued to realign the c1c2 joint, but the patient had a skull fracture from the halo fixation pins. Suture repair in endoscopic surgery for craniovertebral. Two patients had posterior pharyngeal wall infections that were treated conservatively. Since 2002 several anatomic studies emphasized the possibility to access this region through a transnasal corridor. Potentially malignant disorders of the oral cavity and oral dysplasia. May 10, 2007 odontoidectomy may be considered one of the most complicated manoeuvres for the transoral approach, in which the split of the soft and even hard palate is often necessary. Online videos robert m wohar, dmd, jd, king of prussia pa.
Transoral robotic surgery vs transoral laser microsurgery for resection of supraglottic cancer. Mayo clinic school of continuous professional development. The approach did not require forced excessive opening of the jaw, softpalate splitting, or hardpalate resection. Indications include atlantoaxial subluxation with compression of cervicomedullary junction or ventrally located pathology of the lower clivus or atlantoaxial complex. In this article, we describe our experience developing a transoral robotic surgery tors program at western university. Pdf evolution from microscopic transoral to endoscopic. Pdf odontoidectomy has been considered an effective way to treat anterior cervicomedullary compression in patients. The most important bony anatomic landmarks for the transoral approach are the midline structures. Apostolides pj, vishteh ag, sonntag vkh 1998 technique of transoral odontoidectomy. Transoral surgery for head and neck cancer is designed to give otolaryngologists, head and neck surgeons, radiation oncologists, medical oncologists, oral maxillofacial surgeons and other head and neck physicians and interested parties a focused educational experience in transoral endoscopic techniques for resecting primary head and neck tumors. This text gives readers current, thoroughly illustrated, and datadriven information on all aspects of transoral surgery.
Pdf transoral robotic surgery applied to the skull base. Transoral odontoidectomy for decompression of basilar. These can be given painlessly if plenty of topical anaesthetic is used, the bevel is placed against the mucosa, the patient is kept distracted notice the duff singing and the plunger on the syringe is pressed in slowly. Odontoid process pathologies can cause upper motor neuron lesions. The traditionally used transoral route is often challenging due to the increased depth of the surgical corridor and risk of injuries to the soft tissues in the oral cavity. However, these techniques carry a high risk of cerebrospinal. However, these techniques carry a high risk of cerebrospinal fluid csf leakage and wound infection. Wang, md, faans, of the university of miami reduction of locked cervical facets.
A faster, more accurate diagnosis means less chair time for you. Transoral robotic surgery tors is a modern surgical technique used to treat tumors of the mouth and throat via direct access through the mouth. Transoral exposure and microsurgical resection of a translocated odontoid tip in a patient with traumatic cervical myelopathy. Written by some of the most experienced surgeons in the united states, contemporary transoral surgery for primary head and neck cancer is a distinct resource for surgeons and oncologists interested in transoral surgery. Spinal surgery transoral odontoidectomy thrace greece. Spinal surgery transoral odontoidectomy thracegreece. Transoral resection of the odontoid has been accepted as a standard procedure to decompress the cervicomedullary junction during the past several decades.
Our online videos and the ada patient education library provides the most popular topics in dentistry that will help you better maintain your dental health. Florida oral surgery, wisdom teeth removal, watch our videos, wisdom teeth extraction orlando, at florida oral surgery we specialize in treatments of infected teeth as well as options for damaged or missing teeth, providing tooth infection treatment in orlando, sanford, florida. Transoral odontoidectomy is a high risk procedure that can lead to postoperative csf leakage, meningitis, and death 10. Transoral laser microsurgery is a form of minimally invasive surgery used by several medical centers, including the advent health cancer institute, orlando florida advent health celebration and mayo clinic to remove small and medium tumors through the mouth. Clinica dental endodoncia,reabilitacion oral y estetica, ortodoncia popular posts realiza tus citas aqui. Pfd and a craniocervical fusion ccf with transoral odontoidectomy, if necessary. The 3 different approaches for endoscopic odontoidectomy. After impaction of a piece of gelfoam and fat graft, sutured with 30 polysorb were done via transoral approach. Access to the basion and base of c2 in the final head position was confirmed using fluoroscopy. We discuss the feasibility, advantages, and limitations of this surgical approach. The body habitus of the patient must be taken into account before embarking on this procedure.
Endoscopic transoral odontoidectomy for anterior decompression at the c2 level. Vinci robotassisted transoral odontoidectomy for basilar inv agination. Mar 27, 2014 the national institute for health and care excellence nice has issued full guidance to the nhs in england, wales, scotland and northern ireland on transoral carbon dioxide laser surgery for primary treatment of oropharyngeal malignancy, in march 2014. To provide you with a better understanding of wisdom tooth extraction, we have provided the following multimedia presentation. Transoral endoscopic odontoidectomy to decompress the. The endoscopic odontoidectomy includes transnasal, transoral, and transcervical approaches. Head and neck cancer robotic surgery transoral robotic surgery tors tumors in the throat, base of the tongue, and tonsils can be a technical challenge to reach and have traditionally been removed through surgeries requiring a large neck incision and cutting of the bottom jaw. The transoral approach for odontoidectomy is described in detail, and the operating room setup and surgical positioning are demonstrated. Autoplay when autoplay is enabled, a suggested video will automatically play next.
Liu et al 37 introduced a video assisted atlantoaxial transcervical release procedure for anterior release, which can circumvent the limitations of the transoral approach. Our online videos are presented in order to help you understand more about the oral surgery procedures we perform. Endoscopic transnasal anterior release and posterior. Evolution from microscopic transoral to endoscopic.
The patient was completely ventilatordependent with persistent spasticity and worsened quadriparesis 25. Patients with nonreducible craniocervical junction bony compression are candidates for transoral odontoidectomy. Transoral odontoidectomy is the essential surgical intervention directed to treat an odontoid fracture and irreducible subluxation causing ventral compression of the cord. Our online oral surgery videos are presented in order to help you understand more about the oral surgery procedures we perform.
The transoral ventral microsurgical corridor is the most common3 8 9 19 34 approach used to reach the craniovertebral junction cvj anomalies. This video has been taken from transoral odontoidectomy, a manuscript that can be read here. Transoral odontoidectomy is the treatment of choice in cases of anterior bulbomedullary compression. Article information, pdf download for technical notes on the endoscopic. It provides an alternative surgical approach when a transoral odontoidectomy is not possible and should be used with caution by surgeons who are experienced in the transnasal endoscopic approach. The introduction of the surgical microscope, proper instrumentations, and proper antibiotics has increased utilization of the transoral approach. Goels technique contradicts the need for additional anterior odontoidectomy in the majority of patients and we have also found this technique. Praveen v mummanenis 412 research works with 8,267 citations and 2,604 reads, including. The technique of transoral odontoidectomy springerlink. The video endoscope offered a large view inside the sphenoidal sinus, as observed in. These images allow us to make a more accurate diagnosis and develop a better treatment plan for each patient. The patient should be able to open his or her mouth widely enough to accommodate the transoral retraction systems. Oct 24, 2011 this video has been taken from transoral odontoidectomy, a manuscript that can be read here. Endoscopic transnasal anterior release and posterior reduction.
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