A unique procedure of joined transoral and retropharyngeal high cervical approach (JTRC) without mandibulectomy for treating upper cervical neoplasm involving both C2 and C3

Wang, Jianhua; Lü, Yang; Xia, Hong; Yin, Qian

doi:10.1007/s00586-016-4798-4

Cited by 1 publication

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“…Over the past decade, thousands of transoral approach operations have been performed in our hospital, through which we have accumulated rich clinical experience in surgical treatment of craniovertebral junction disorders. Moreover, our hospital has successfully treated patients with difficult and complex diseases, such as adult/infant congenital basilar depression [ 7 ], refractory/irreversible atlantoaxial dislocation [ 9 , 29 ] and atlantoaxial tumor [ 30 ] or inflammation occupying lesion [ 31 ], and further improved and summarized relevant key points of operations [ 32 ], such as the classification and surgical treatment of developmental canal stenosis at atlas level [ 33 ], axial reverse pedicle screw placement [ 34 , 35 ] and atlantoaxial posterior combined screw placement [ 9 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Research on pharyngeal bacterial flora in transoral atlantoaxial operation and the postoperative follow-up study

You

Zhou

et al. 2022

BMC Musculoskelet Disord

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Objectives To study the changes of bacterial flora after a series of preoperative oral disinfection and the postoperative recovery of nerve function of patients with craniovertebral junction disorders who were treated with transoral approach operations. Methods This research analyzed 20 cases collected from October 2009 to May 2010. All these patients were with CVJ disorders, including 8 males and 12 females, aged 2 to 66 (38.1 on average), and they were all treated with transoral approach operations. The mucosa samples of the posterior pharyngeal wall were sent for bacteria culture. These samples were collected by sterile cotton swabs at four crucial points, including 3 days before operation/before gargling, 3 days after continuous gargling/after anesthesia intubation on the day of operation, after intraoperative cleaning and washing of the mouth, and after intraoperative iodophor immersion. The microflora was stained by means of smear and further counted after an investigation by microscope. The neural function of patients was evaluated by the ASIA classification and the JOA scores. All patients but two with posterior stabilization performed respectively underwent transoral atlantoaxial reduction plate (TARP) fixation consecutively in the same sitting. A regular reexamination of cervical vertebra with lateral and open mouth X-ray, CT and MRI was conducted after operation to evaluate the reduction of atlantoaxial dislocation, internal fixation position, bone graft fusion, inflammatory lesions and tumor recurrence. Results This bacteriological research showed that the mucosa of the posterior pharyngeal wall of all the patients was in a sterile state after a series of oral preoperative preparations and intraoperative iodophor disinfection, which was considered as type I incision. The bacterial culture results of the mucosa samples of the posterior pharyngeal wall collected at different time points showed significant differences (χ2 = 42.762, P = 0.000). All the patients had improvement in ASIA, and their neural functions were improved to different levels after operation. There was a significant difference in JOA scores before and after operation (t = 8.677, P = 0.000). Postoperative imaging examination showed that the atlantoaxial screw position was good and firm, and the CVJ disorders were treated appropriately. Conclusion It is safe and effective to cut the posterior pharyngeal muscle layer and implant internal fixation by means of transoral approach.

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Section: Discussionmentioning

confidence: 99%

Research on pharyngeal bacterial flora in transoral atlantoaxial operation and the postoperative follow-up study

You

Zhou

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

A unique procedure of joined transoral and retropharyngeal high cervical approach (JTRC) without mandibulectomy for treating upper cervical neoplasm involving both C2 and C3

Abstract: The JTRC approach could provide good surgical exposure for treating disorders involving both upper and lower cervical spine without splitting up the mandible.

Cited by 1 publication

References 15 publications

Research on pharyngeal bacterial flora in transoral atlantoaxial operation and the postoperative follow-up study

Research on pharyngeal bacterial flora in transoral atlantoaxial operation and the postoperative follow-up study

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