[The transoral approach in neurosurgical practice]

Operations were performed on 25 patients by the transoral approach. All of the pathological processes were localized epidurally in the clival, craniocervical or upper cervical regions. These were tumors, developmental anomalies, inflammatory processes, and odontoid fracture with compression of the brain stem, cranial nerves, spinal cord or spinal radices. The advantages of the transoral operation are obvious in decompressing the neural structures from the direction of the exerted pressure. Surgery led to improvement in the 25 primarily operated patients and there was no operative mortality. Among 7 reoperations an emergency and tenable transoral reoperation (C2-4 twice recurrent chordoma) undertaken to relieve respiratory arrest, however, was only a transitory success.