Thieme｜经口咽入路到达颅颈交界区图解

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精华摘录：Transoral Approach to the Craniovertebral Junction

来源：Thieme MedOne 神经外科

Fig. 1.1 (A) Transoral approach showing incised soft palate and pharynx. Hatched line demonstrates location and extent of incision in relation to palate and uvula. 1. Posterior pharyngeal wall incision; 2. soft palate incision. (B) Transoral approach showing incised soft palate, pharynx, and exposed anterior longitudinal ligament, with incision line shown through the ligament. (C) Exposure of atlas (C1) and axis (C2) bones. The transoral retraction system will allow good exposure of C1 and C2 with retraction of the soft palate, nasotracheal, and nasogastric tubes.

Fig. 1.2 Lateral (sagittal) view demonstrating anatomic structures including extent of opening the mouth, location of the retractor, and positioning of the endotracheal tube. Note the retraction of the soft tissues and ligaments. Curette shown at the level of the C2 dens with pannus shown at that level.

Fig. 1.3 (A) Transoral resection of the odontoid process is demonstrated. If there is significant odontoid translocation far behind the anterior rim of the foramen magnum, the best way to extract it is by drilling across the base of the peg, loosening the ligaments around it, and using the grasping forceps to pull it gently out of the head. (B) Anatomic detail shown after resection of the odontoid process. VA, vertebral artery.