Complications of transoral and transnasal odontoidectomy: a comprehensive review

Tubbs RS, Demerdash A, Rizk E, Chapman JR, Oskouian RJ.Complications of transoral and transnasal odontoidectomy: a comprehensive review.Childs Nerv Syst. 2016 Jan;32(1):55-9. doi: 10.1007/s00381-015-2864-6.



Odontoidectomy has been considered an effective way to treat anterior cervicomedullary compression in patients presenting with craniocervical joint anomalies. The transoral and transnasal routes have been described for anterior decompression surgery. However, to date, a comprehensive review of the complications from this procedure is lacking in the extant medical literature. Therefore, herein, we review this specific literature as a resource for surgeons.


A comprehensive review of the literature via online search engines was performed.


The most reported complications for odontoidectomy are CSF leakage, postoperative craniocervical instability, velopharyngeal insufficiency, wound dehiscence, pulmonary issues, meningitis, and death. To our knowledge, this is the first comprehensive review of complications of odontoidectomy. Increased awareness of the more common complications associated with this procedure may help in the care of patients in the future.