Transoral approach for epidural craniocervical pathological processes.

Transoral surgery for ventral craniocervical pathology is an integral part of modern neurosurgery. This approach should be considered in many more cases than in current practice. On the basis of our experiences with 15 operations in 13 patients we feel able to improve the surgical technique in some small details, as 1. the double, two flap incision of the posterior wall of the pharynx, 2. the method of "deep" resection of the odontoid in its high upward and backward position, and 3. insertion of bone grafts and chips in the cavity of tumorous vertebrae for fixation. Admittedly, these cases are not encountered every day in neurosurgical units. An exact knowledge of the anatomical, neurological, pathological, radiological and surgical details is of vital importance and constitutes the basis of this account. This method should not be confined to specialised regional neurosurgical centres, but is within the technical capacity of all trained neurosurgeons.