Cervical ganglion 2 (CG2) neurectomy: A window to the atlantoaxial joint

摘要

The transoral approach allows decompression from the level of the ventral medulla to the upper cervical spinal cord. In most circumstances, the transoral approach permits access from the inferior third of the clivus to the C3 vertebra. Exposure is constrained by patients' ability to open their mouths and by the soft tissue boundaries of the nasopharynx, oral pharynx, mandible, and skull base. The usual transoral access to the CVJ is through the uncomplicated route that involves retraction of the soft palate and the tongue without incising other soft tissue. If extended exposure is required, the transoral approach can proceed via a transmaxillary, transpalatal, transfacial, or transmandibular exposure. Although such extensions of the transoral exposures offer access, they also increase the morbidity associated with this surgical procedure.