Transpalatal excision of the odontoid process

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Skull Base Surgery

Background:

• Platybasia is a congenital disorder characterized by basilar invagination of the skull.
• Temporomandibular joint (TMJ) ankylosis can lead to significant functional limitations.
• Compression of the brain stem by the odontoid process is a critical complication.

Observation:

• A patient presented with both platybasia and TMJ ankylosis.
• The odontoid process impinged upon the brain stem due to a hypoplastic clivus.
• Limited mouth opening was a consequence of TMJ ankylosis.

Findings:

• A two-stage surgical intervention was performed.
• Mandibular condylectomy was utilized to achieve adequate mouth opening.
• A transoral-transpharyngeal approach enabled the successful excision of the odontoid process.

Implications:

• This surgical strategy effectively decompress ed the brain stem.
• The combined approach addresses complex craniofacial and neurological issues.
• Successful management of platybasia with TMJ ankylosis can improve patient outcomes.