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Transoral approach to the upper cervical spine
G E Merwin1, J C Post, G W Sypert
1Division of Otolaryngology-Head and Neck Surgery, University of Florida College of Medicine, Gainesville.
The Laryngoscope
|July 1, 1991
Summary
The transoral approach offers a safe and effective method for treating upper cervical spine pathologies, including tumors and spinal cord compression. This minimally invasive technique avoids major complications and yields excellent functional outcomes.
Area of Science:
- Neurosurgery
- Otolaryngology
- Spinal Surgery
Background:
- The transoral approach to the upper cervical spine is anatomically logical but underutilized due to exposure and infection concerns.
- Pathologies from the clivus to C3 require specialized surgical access.
Purpose of the Study:
- To evaluate the safety and efficacy of the transoral approach for upper cervical spine pathologies.
- To assess outcomes in patients undergoing this surgical technique.
Main Methods:
- A consecutive series of 16 patients with upper cervical spine pathology underwent transoral exposure.
- Surgical technique involved a Dingman mouth gag, soft palate retraction, and a three-layer posterior pharyngeal wall incision.
- Watertight mucosal closure was prioritized.
Main Results:
- No deaths, wound breakdowns, infections, or cerebrospinal fluid leaks occurred.
- Neurological deficits improved postoperatively, and all tumors were grossly resected.
- No division of mandible, tongue, soft palate, or uvula was necessary.
Conclusions:
- The combined otolaryngology/neurosurgical transoral approach is a safe and effective option for upper cervical spine pathology.
- Excellent functional results and minimal major complications were observed.
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