Transoral surgery for craniocervical space-occupying processes

Pásztor, E.; Vajda, J.; Piffkó, P; Horváth, Miklós; Gádor, Ildikó

doi:10.3171/jns.1984.60.2.0276

Cited by 66 publications

(15 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The rates were particularly bad for patients with CCJ malformations 2, 14, 33 and intradural lesions 5' 13, 15, 17 Today, the transoral approach is a well-established surgical procedure 1' 2,5,6,7,8,11,12,13,15,17,21,23,24,26,28,30 In particular, the transoral approach in the treatment of CCJ anomalies became standard largely thanks to two developments. First came improved radiological assessement of CCJ abnormalities, including multiplanar CT scanning 9' 29 and MR118' 19, 29, on the one hand, and on the other, technological advances such as the operating microscope, high-speed drill, and extra-long surgical instruments.…”

Section: Discussionmentioning

confidence: 99%

Craniocervical junction malformation treated by transoral approach. A survey of 25 cases with emphasis on postoperative instability and outcome

Lorenzo

1992

Acta neurochir

100

View full text Add to dashboard Cite

An experience with 25 consecutive cases of craniocervical junction (CCJ) malformations operated upon via the transoral route is reported. Twenty-two patients also underwent posterior occipito-cervical stabilization with alloplastic material and in only one patient was transoral odontoidectomy and fusion with bone autograph performed. Indication for the transoral route consisted of an irreducible ventral compression of the cervicobulbar junction by the abnormal bone complex. Two patients died during the early postoperative period and the remaining 23 survivors were followed for an average of 3.5 years: 17 of these showed marked improvement and 5 a stabilization of the neurological disturbances. A further patient, who refused posterior stabilization, eventually died because of progressive cranial settling. Long-term results have shown this approach to be decisive in the surgical management of well-selected CCJ anomalies.

show abstract

Section: Discussionmentioning

confidence: 99%

Craniocervical junction malformation treated by transoral approach. A survey of 25 cases with emphasis on postoperative instability and outcome

Lorenzo

1992

Acta neurochir

100

View full text Add to dashboard Cite

show abstract

“…1,2,8,15,18,21,24,33,36,39,43,46 However, there were some management variations that warrant further explanation. 1,2,8,15,18,21,24,33,36,39,43,46 However, there were some management variations that warrant further explanation.…”

Section: Technical Variations For Transoral Operations In Pediatric Pmentioning

confidence: 99%

Pediatric transoral surgery: indications, complications, and long-term outcome

Gf¹,

Veres²,

Ha³

et al. 1996

Journal of Neurosurgery

113

View full text Add to dashboard Cite

Knowledge of the role and hazards of transoral surgery has expanded rapidly, but the application of this technique in children has been limited. To assess its usefulness, 27 pediatric patients who underwent transoral surgery between 1985 and 1994 were studied. Transoral surgery was performed for irreducible anterior neuraxial compression at the craniovertebral junction caused by basilar impression, atlantoaxial subluxation with pseudotumor, or chordoma. The patients ranged in age from 3 to 17 years. Symptomatic presentation varied widely, but 89% had significant neurological deficits before surgery. No patient with normal strength deteriorated after surgery. Of the 16 patients with a preoperative motor deficit, nine improved rapidly, three were unchanged, and four significantly worsened in the perioperative period. Those with mobile atlantoaxial subluxation were most vulnerable to surgically related neurological morbidity. Twenty-four patients were alive for long-term follow-up study (average 5.7 years, range 1-9.2 years). Of those with preoperative weakness, nine improved one Frankel grade, four remained the same, and one deteriorated from Frankel Grade D to C. Swallowing and speech worsened in five patients; this occurred only after resection of lesions above the foramen magnum (p<0.05) when rostral pharyngeal disruption resulted in velopharyngeal dysfunction. This study, unlike previous reviews of pediatric transoral operations, leads the authors to suggest that although transoral surgery can be effective, it also carries a significant risk of neurological injury in patients with symptomatic spinal cord compression and it is also associated with long-term swallowing and speech difficulties.

show abstract

“…Several approaches to these regions have been developed through anterior, antero-lateral and postero-lateral routes [6,34,36,67,93,104,111,118,128]. The most physiological and shortest route to the clival area and the anterior aspect of the cranio-vertebral junction is represented by an anterior approach through the pharynx.…”

Section: Approach To the Ethmoidal Planummentioning

confidence: 99%