Transoral-Transpalatine-Transclival Approach to Aneurysms of the Vertebral and Basilar Artery

Transoral operations for craniospinal malformations

“…I) has shown that this method is more suitable for a primary decompression [8,12,14,24,26,37,40,41,45,46,48,49,64] than a laminectomy, which is associated with a high rate of complications [1,7,11,23]. If beyond these indications the transoral approach is recommendable for fusion operations in congenital craniospinal instabilities [47], remains open, nevertheless successful fusion operations have been done in traumatic lesions of C1 and C2 [17, 18, 33, 34, 62]. According to the literature it also seems impossible to give an answer to the question whether craniospinal malformations with dislocation should be decompressed and fused primarily by a transoral route or if a dorsal stabilization before or after a transoral decompression [24,40] is indicated.…”

“…Originally the approach was used in treatment of infections of the upper cervical spine [19,49,63]. Up to now numerous communications exist, which recommend this approach for the treatment of basilar aneurysms [15,16,31,32,39,47,50,51,52,64,69,70], ventrally situated craniospinal tumours [2,5,9,10,25,27,36,38,42,43,44,46,53,57,61,64,65,68], and for the fusion or resection of fractured parts in craniospinal traumatic lesions [4,10,17,18,19,22,24,29,30,33,34,40,46,58,62,64]. This approach also allows a direct treatment of...…”