Transoral clivectomy; (a case report)

A transoral approach to the basilar artery was developed. The operation involved midline division of the palate followed by reflection of an inferiorly based pharyngeal flap to expose the clivus. A window was cut in the bone and the dura mater incised to allow access to the vertebral-basilar vasculature. The advantage of this approach lies in the direct exposure of the basilar artery and related brain stem. It ensures delicate structures are not damaged, thus reducing operative mortality and morbidity.