Dr. Mindea is the director of the minimally invasive spine program and co-director of the spinal oncology surgery program at Stanford University Medical Center. Dr. Nayak is an assistant professor and co-director of the Stanford Sinus Center.
The 67-year-old patient’s physicians found a mass at the top of her spinal column where it meets the brain stem. Dr. Mindea and Dr. Nayak decided to perform a procedure that would reach her spine through her sinuses, the endonasal odontoidectomy. The procedure had never been done at Stanford and is estimated only to have been performed less than 36 times worldwide.
Traditional surgery would have taken the instrumentation through the side of the neck or the mouth, which requires a longer recovery time and involves the risk of adverse effects on swallowing, breathing and speech. However, new imaging technology and surgical tools that are more flexible, optically sharper and smaller allow the surgeon to perform the procedure though the nasal cavity and the sinus to the eye and brain.
To perform the surgery, Dr. Nayak followed the landmark clivus bone through the patient’s sinus about 12 centimeters from the nostril margins until he neared the skull base and C1 vertebrae. Dr. Mindea then used extended ultrasonic aspirators to rapidly vibrate the diseased bone, which removed the soft tissues at a high frequency, causing them to disintegrate and be suctioned up.
The transnasal approach can be advantageous because “for the right patient, you can get to a site of interest with much less pain and dissection through normal tissues,” Dr. Nayak said in the release. “For the patient, this can translate to going home sooner and with much less pain and possibility of issues that go along with more traditional surgery.”
Read the Stanford Hospitals & Clinics news release on the endonasal odontoidectomy.
Read other coverage on spinal procedures:
– Minnesota Spine Surgeon Performs XLIF
– Dr. Steven Garfin Performs Three Revision Spine Surgeries to Correct Patient’s Degeneration
– 5 Points on Cervical Spine Surgery
