Harris J P, Godin M S, Krekorian T D, Alksne J F
Division of Otolaryngology--Head and Neck Surgery, University of California, San Diego Medical Center 92103.
Laryngoscope. 1989 May;99(5):467-74. doi: 10.1288/00005537-198905000-00001.
The transoropalatal approach to the atlantoaxial-clival area provides excellent exposure for neurosurgical decompression and fusion procedures. The technique has been effectively applied in the treatment of bony and soft tissue abnormalities of the anterior spinal region. Although this approach is safe and reliable, it is not part of the otolaryngologist's usual surgical armamentarium. In the present study, we describe the case histories of five patients who underwent resection of the odontoid process for cervicomedullary compression. Neurological compromise was manifested by progressive upper and/or lower extremity paresis in all patients. In each patient, a transoropalatal approach was used. The surgical technique is discussed, and the prevention of possible sequelae, including velopharyngeal incompetence and palatal or pharyngeal wound dehiscence, is addressed.
经口腭入路至寰枢椎-斜坡区可为神经外科减压和融合手术提供极佳的视野。该技术已有效地应用于治疗脊柱前部区域的骨与软组织异常。尽管此入路安全可靠，但它并非耳鼻喉科医生常用的手术手段。在本研究中，我们描述了5例因颈髓受压而行齿状突切除术患者的病史。所有患者均表现为进行性上肢和/或下肢轻瘫导致的神经功能损害。每例患者均采用经口腭入路。本文讨论了手术技术，并阐述了对包括腭咽功能不全及腭部或咽部伤口裂开等可能后遗症的预防措施。
