Abstract | BACKGROUND:
Basilar impression (BI) is an uncommon condition in which there is upward displacement of the elements forming the foramen magnum, causing translocation 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:
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Authors | Chetan Bettegowda, Mehdi Shajari, Ian Suk, Oliver P Simmons, Ziya L Gokaslan, Jean-Paul Wolinsky |
Journal | Neurosurgery
(Neurosurgery)
Vol. 69
Issue 1 Suppl Operative
Pg. ons77-82; discussion ons82
(Sep 2011)
ISSN: 1524-4040 [Electronic] United States |
PMID | 21415781
(Publication Type: Case Reports, Journal Article)
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Topics |
- Adult
- Brain Stem
(abnormalities)
- Female
- Humans
- Klippel-Feil Syndrome
(complications, surgery)
- Neurosurgical Procedures
(methods)
- Platybasia
(surgery)
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