[Osteochondroma of the atlantooccipital joint. Extreme lateral transcondylar approach. A case description].

Abstract:

INTRODUCTION:We describe a patient diagnosed as suffering from a skull base osteochondroma which affected the atlantooccipital joint and originated in the occipital condyle. It also displayed a growth toward the foramen magnum, which was resected using an extreme lateral transcondylar approach. CASE REPORT:Patient aged 35, with a one year history of vertiginous seizures and unsteady gait, associated with cervical pain that irradiated to the right upper extremity, dysphagia, changes in the tone of the voice and distal numbness of the four extremities. The patient was made to lie in the three quarter prone position and an incision was made in the skin from the C3 spinous apophysis to a point 2 cm below the end of the mastoid process, in relation with the transversal apophysis of C1. The intervention continued with early identification and rotation of the vertebral artery; total resection of the tumour (osteochondroma) with its base in the right occipital condyle and growth toward the foramen magnum, in which the greater resection of the posteromedial third of the condyle is included. CONCLUSIONS:The location of osteochondromas can vary widely, and the condyle is one of the least frequent places inside the occipital bone. The approach employed provides excellent access to the region, in particular to the atlantooccipital joint. The width and angle of exposition are increased as compared with the traditional suboccipital approach, which facilitates the radical resection of the lesion with no neural retraction and without any surgical complications.

journal_name

Rev Neurol

journal_title

Revista de neurologia

authors

López-Flores G,Cruz-García O,Fernández-Melo R,Fernández-Alban M,Alfonzo-Sabatier C,Bouza-Molina W,Fermín-Hernández E,Castillo-Hernández JE

subject

Has Abstract

pub_date

2003-01-16 00:00:00

pages

133-6

issue

2

eissn

0210-0010

issn

1576-6578

pii

rn2002273

journal_volume

36

pub_type

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