[Ventral approaches to the upper cervical spine].

Area of Science:

• Neurosurgery
• Otolaryngology
• Spine Surgery

Background:

• The transoral approach to the upper cervical spine and neuraxis has been known for a century but is infrequently utilized.
• This technique provides access to critical anatomical structures at the skull base and upper cervical region.

Purpose of the Study:

• To outline the pathological mechanisms, surgical anatomy, and indications for the transoral approach.
• To describe variations, extensions, preoperative investigations, and surgical techniques for this approach.
• To discuss common lesions, tumors, complications, and postoperative care related to transoral surgery.

Main Methods:

• Review of over 200 surgical operations performed using the transoral approach.
• Analysis of patient data including age range (2.5 to 83 years) and diverse pathologies.
• Detailed description of surgical anatomy, techniques, and management strategies.

Main Results:

• The transoral approach was successfully applied to a wide spectrum of lesions and tumors in the upper cervical spine and skull base.
• Common post-traumatic lesions and frequent tumors were identified and addressed with the described surgical approach.
• Complications and their management were analyzed, alongside recommended postoperative care protocols.

Conclusions:

• The transoral approach is a valuable, albeit underutilized, surgical option for pathologies of the upper cervical spine, neuraxis, and skull base.
• Comprehensive understanding of surgical anatomy, indications, and techniques is crucial for successful application.
• This approach, when properly executed, offers effective management for various complex conditions.