OBJECTIVETo discuss the surgical methods and clinical effect of endoscopic transoropharyngeal approach to deal with the lesions of the ventral region of the craniocervical junction.

METHODSFrom August 2002 to November 2006, endoscopic transoropharyngeal approach was taken to deal with the lesions of the ventral region of the craniocervical junction, including 6 patients with chordoma, 5 patients with craniovertebral malformation, 3 patients with skull-base invagination combined with Chiari malformation, 2 patients with odontoid fracture . 0 degrees endoscope was used to deal with the lesions of middle and lower clivus, 30 degrees endoscope was used to deal with the lesions of craniovertebral malformation.

RESULTSFollow-up ranged from 2 to 48 months. Three patients with chordoma recurred. All patients with craniovertebral malformation recovered.

CONCLUSIONSEndoscopic transoropharyngeal approach is a new method to deal with the lesions of the ventral region of the craniocervical junction, and it has many advantages, such as direct approach, good exploration, micro-invasive, wide operation space, and good results.