Transtubular Transoral Surgery for Excision of a Dystrophic Os Odontoideum: A Case Report.

Transoral approach to the cervico-medullary junction is a well-established procedure. However oropharyngeal complications in the form of soft tissue morbidity postoperatively do occur. We report a case of a teenage boy with traumatic quadriparesis secondary to compression of the cervico-medullary junction by an os odontoideum. Decompression was done via transoral approach through a tubular retractor system, hence obviating the need for the splitting or separate retraction of the soft palate and minimised the damage and violation of surrounding soft tissues. His neurological status improved and he was able to ambulate with support on fourth post-operative day with no soft tissue morbidity in the oral cavity. To our knowledge this is the first case reported using this technique. We conclude that adoption of this method would improve the traditional transoral approach and reduce the oropharyngeal complications.