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Transcervical approaches to the prevertebral space
R L Carrau1, F R Cintron, F Astor
1Department of Surgery, Keesler USAF Medical Center, Keesler AFB, MS 39534-5300.
Archives of Otolaryngology--Head & Neck Surgery
|September 1, 1990
Summary
This study compared two surgical approaches for diffuse idiopathic skeletal hyperostosis (DISH). Both anterolateral and posterolateral transcervical techniques effectively relieved swallowing difficulties in patients with DISH with no complications.
Area of Science:
- Neurosurgery
- Orthopedics
- Gastroenterology
Background:
- Diffuse idiopathic skeletal hyperostosis (DISH) can cause dysphagia due to anterior cervical osteophytes.
- Surgical intervention is sometimes necessary to relieve dysphagia in DISH patients.
Purpose of the Study:
- To compare the efficacy and safety of anterolateral and posterolateral transcervical approaches for exposing the prevertebral space in DISH patients.
Main Methods:
- Retrospective review of six patients with DISH who underwent either anterolateral or posterolateral transcervical surgery.
- Surgical outcomes, including palliation of dysphagia and associated morbidity, were assessed.
Main Results:
- Both anterolateral and posterolateral transcervical approaches provided effective palliation of dysphagia.
- No significant morbidity was associated with either surgical technique.
- The anterolateral approach theoretically better preserves the carotid sheath but carries a higher risk to the recurrent laryngeal nerve.
- The posterolateral approach offers wider exposure but increases risks to the carotid sheath and sympathetic chain.
Conclusions:
- Both anterolateral and posterolateral transcervical approaches are effective for managing dysphagia in DISH.
- The choice of surgical technique may depend on surgeon preference and the specific anatomical considerations.