gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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

Meeting Abstract

  • corresponding author J. Kaminsky - Department of Neurosurgery, Tübingen University Hospital, Tübingen
  • J. Hoffmann - Department of Oral and Maxillofacial Plastic Surgery, Tübingen University Hospital, Tübingen
  • H. Löwenheim - Department of Otolaryngology, Head and Neck Surgery, Tübingen University Hospital, Tübingen
  • T. Niemeyer - Department of Orthopedic Surgery, Tübingen University Hospital, Tübingen
  • U. Ernemann - Department of Diagnostic Radiology, Tübingen University Hospital, Tübingen
  • A. Gharabaghi - Department of Neurosurgery, Tübingen University Hospital, Tübingen
  • M. Tatagiba - Department of Neurosurgery, Tübingen University Hospital, Tübingen

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc10.05.-07.06

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0119.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Kaminsky et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

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.