The Transoropalatal Approach to the Atlantoaxialclival Region: Considerations for the Head and Neck Surgeon

Abstract

At the meeting of the Western Section of the Triological Society in Laguna Niguel, Calif, Michael S. Godin, MD, San Diego, Calif, commented on the transoropalatal approach to the atlantoaxialclival region. Godin stated that this was a direct, reliable, and safe approach that provided excellent exposure for neurosurgical decompression and fusion procedures in this area. It was felt that this approach was not widely used because the otolaryngologist was not familiar with it. Godin presented a series of five cases detailing the basic technique, which could be combined with other techniques, such as median palatal split, lip split, mandibular split, and glossal splits, to enhance exposure. Of the five cases presented, some degree of velopharyngeal insufficiency developed in two. The basic techniques consisted of a superiorly based U-shaped flap to expose cervical vertebrae C-1 and C-2. This flap has the advantage of being technically easy, providing excellent exposure, and resulting