Surgical Experience of Basilar Invagination by Transoral Transpharyngeal Approach

ABSTRACT

Basilar invagination or basilar impression involves the upward displacement of the margins of the foramen magnum into the base of the skull. That this entity may be asymptomatic or associated with symptoms referable to encroachment into the posterior fossa or embarrassment of the posterior circulation is well known. Currently the authors have experienced a young male patient with basilar invagination presented with progressive myelopathy and lower cranial neuropathies due to odontoid invagination. It was thought that a posterior decompression would be hazardous;therefore, the inferior clivus, odontoid process, and anterior arch of the atlas were removed transoral-transpharyngeally and bone fusion was performed with iliac bone. Furthermore the operative result was good without any serious complication. The operation technique is detailed.