Surgical approaches: postoperative care and complications "transoral-transpalatopharyngeal approach to the craniocervical junction".

作者: Arnold H. Menezes

DOI: 10.1007/S00381-008-0599-3

关键词: Os OdontoideumBasilar invaginationSurgeryFibrous dysplasiaForamen magnumCervicomedullary JunctionMedicineClivusChordomaDystopic os odontoideum

摘要: The ventral approach to the craniocervical border has been described for decompression of irreducible extradural pathology. procedures utilized encompass transoropharyngeal and median mandibulotomy with glossotomy transpalatal procedures. This study was aimed review utility transoral–transpalatopharyngeal approach. Seven hundred thirty-three patients underwent transpalatopharyngeal brain stem cervicomedullary junction. Of these, 280 were children below age 16 years. main indication pathology compressing Two two had basilar invagination, 28 proatlas segmentation abnormalities, os odontoideum a dystopic in 30, spinal tumors seven (chordoma, fibrous dysplasia, osteoblastoma). Down’s syndrome bony compression junction seen. There six other miscellaneous diagnoses. All required stabilization which carried out under same anesthetic as transoral procedure. procedure entailed fiber-optic intubation. patient placed cervical traction prior anterior soft palate split only individuals short clivus high riding clivus-odontoid articulation. Craniocervical performed prone position anesthetic. one retropharyngeal infection postoperatively. No cesium fluoride leaks encountered. Velopalatine incompetence seen five who already preoperative dysfunction. Neurological recovery rule. Patients syringohydromyelia resolution syrinx on postoperative magnetic resonance imaging. author’s technique is described. Since 1977, 732 (280 children) evolved into safe direct minimal morbidity mortality.

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