Endoscopic endonasal resection of the odontoid peg for paediatric basilar invagination

Area of Science:

• Neurosurgery
• Genetics
• Pediatrics

Background:

• Osteogenesis imperfecta (OI) is a genetic disorder characterized by bone fragility, fractures, deformity, and pain.
• Basilar invagination, leading to brainstem compression, is a rare but severe complication in children with OI.
• Conventional anterior decompression for basilar invagination involves an open trans-oral approach, often associated with significant morbidity.

Observation:

• A rare, life-threatening complication of Osteogenesis imperfecta (OI) is brainstem compression caused by basilar invagination.
• Children with OI and basilar invagination frequently require extensive medical care and hospitalizations.
• The traditional surgical method for anterior decompression involves an open trans-oral route.

Findings:

• This study details an endoscopic endonasal approach for resecting the odontoid peg in a pediatric patient with OI and basilar invagination.
• The endoscopic endonasal technique was successfully employed for decompression in a child with OI and basilar invagination.
• This minimally invasive approach facilitated the removal of the odontoid peg causing brainstem compression.

Implications:

• The endoscopic endonasal approach presents a viable alternative to open trans-oral surgery for OI-related basilar invagination in pediatric patients.
• This technique may significantly reduce patient morbidity and shorten hospital stays compared to traditional methods.
• Further adoption of this endoscopic approach could enhance surgical outcomes and patient recovery in pediatric OI cases with basilar invagination.