Objective: To discuss transoral microcervical treatment of 16 patients with craniocervical malformation.
Methods: Perioperative treatment including antibiotics, tracheotomy, intravenous nutrition was used in 16 patients.
Results: Eight patients had basilar impressions, 3 chronic atlantoaxial dislocation and 2 odontoid fracture, 2 lower clivus chordoma, and 1 granuloma in the ventral part of the medulla oblongata. Three patients received bone graft. Follow-up for 6 - 36 months showed that 14 patients resumed normal life but 1 died.
Conclusions: Pre-craniocervical malformation can be treated by transoral approach microsurgically. Understanding microanatomy of this approach can reduce postoperative morbidity and complications. Perioperative treatment can prevent incision infection. Prevention of intraoperative CSF leakage must be emphasized.Bone graft can make craniocervical spine stable.