Artikel
Transoral translabial transmandibular approach to the clivus and high cervical region: video demonstration of the surgical technique
Transoral, translabial, transmandibulärer Zugang zum Clivus und dem kraniozervikalen Übergang: Videodemonstration des operativen Vorgehens
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
Tumors involving the clivus and high cervical region may be challenging to treat. We describe in detail our technique to access these lesions by a multidisciplinary approach, emphasising surgical steps to allow maximal surgical exposure, to achieve satisfactory cosmetic results and to prevent complications.
Methods
A 38-year-old man presenting with a recurrent clivus chordoma extending inferiorly into the high cervical spine was admitted to hospital. Neurological and radiological investigation demonstrated a craniocervical instability as well. The patient underwent multidisciplinary surgical treatment by a transoral translabial transmandibular approach without glossotomy.
Results
The approach provided proper surgical exposure allowing anterior tumor removal. The patient’s postoperative period was uneventful. In a second procedure the posterior extension of the tumor was resected through a posterior cervical approach. A stabilization of the craniocervical junction was performed during this second procedure. A video demonstrating the surgical steps is presented.
Conclusions
The transoral translabial transmandibular approach with lateral tongue retraction provides wide surgical exposure allowing tumor resection of the craniocervical junction. A glossotomy can be avoided. Excellent cosmetic results may be achieved by performing the described surgical technique.