Transtubular Transoral Approach for Irreducible Ventral Craniovertebral Junction Compressive Pathologies: Surgical Technique and Outcome
https://doi.org/10.5704/MOJ.2307.006
- Author:
Ariffin MH
1
;
Mohd-Mahdi SN
2
;
Baharudin A
1
;
M.Tamil A
3
;
Abdul-Rhani S
1
;
Ibrahim K
1
;
Ng BW
1
;
Tan JA
1
Author Information
1. Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
2. Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
3. Department of Public Health, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Publication Type:Journal Article
- Keywords:
transoral approach, craniovertebral junction, myelopathy, os odontoideum, odontoidectomy
- From:Malaysian Orthopaedic Journal
2023;17(No.2):35-42
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: To investigate the use of a tubular retractor to
provide access to the craniovertebral junction (CVJ) sparing
the soft palate with the aim of reducing complications
associated with traditional transoral approach but yet
allowing adequate decompression of the CVJ.
Materials and methods: Twelve consecutive patients with
severe myelopathy (JOA-score less than 11) from ventral
CVJ compression were operated between 2014-2020 using a
tubular retractor assisted transoral decompression.
Results: All patients improved neurologically statistically
(p=0.02). There were no posterior pharynx wound infections
or rhinolalia. There was one case with incomplete removal of
the lateral wall of odontoid and one incidental durotomy.
Conclusions: A Tubular retractor provides adequate access
for decompression of the ventral compression of CVJ. As the
tubular retractor pushed away the uvula, soft palate and
pillars of the tonsils as it docked on the posterior pharyngeal
wall, the traditional complications associated with traditional
transoral procedures is completely avoided.
