Contralateral Submandibular Retropharyngeal Approach for Recurred High Cervical Chordoma

  • Kim, Seok-Won (Department of Neurosurgery, College of Medicine, Chosun University) ;
  • Shin, Ho (Department of Neurosurgery, College of Medicine, Chosun University)
  • Published : 2006.03.30

Abstract

The C2 level is the transition zone between the cranial and cervical spine. Because of its high position and anatomic relationship to vital structures, exposing C2 is challenging and the surgical approach is controversial. We report a of a recurred chordoma in C2 portion, occupying the osseous intraspinal portion. The patient underwent total corpectomy of C3 and gross total removal of tumor by right submandibular approach 3 years previously. We performed a lateral extrapharyngeal approach from contralateral left side with resection C2 central portion followed by gross total removal of mass and placement of graft bone. Although there was transient hypoglossal nerve palsy postoperatively, the patient had full recovery.

Keywords

References

  1. Ammirati M, Ma J, Cheatham ML, Mei ZT, Bloch J, Becker DP : The mandibular swing-transcervical approach to the skull base : anatomical study. J Neurosurg 78 : 673-681, 1993 https://doi.org/10.3171/jns.1993.78.4.0673
  2. Arbit E, Patterson RH : Combined transoral and median labiomandibular glossotomy approach to the upper cervical spine. Neurosurgery 8 : 672- 674, 1981 https://doi.org/10.1227/00006123-198106000-00006
  3. Bhangoo RS, Crockard HA : Transoral exposure Operative Neurosurgery, ed5 Churchill Livingstone, 2000, pp1399-1415
  4. Cho KH, Cho KG, Jung N : Transoral approach for the lesion of craniovertebral junction and atlantoaxial dislocation. J Korean Neurosurg Soc 25 : 2317-2325, 1996
  5. de Andrade JR, Macnab I : Anterior occipitocervical fusion using an extrapharyngeal exposure. J Bone Joint Surg 51A : 1621-1626, 1969
  6. Delgado TE, Garrido E, Harwick RD : Labiomandibular, transoral approach to chordomas in the clivus and upper cervical spine. Neurosurgery 8 : 675-679, 1981 https://doi.org/10.1227/00006123-198106000-00007
  7. Eleraky MA, Llanos C, Sonntag VKH : Cervical corpectomy : report of 185 cases and review of the literature. J Neurosurg 90 : 35-41, 1999 https://doi.org/10.3171/jns.1999.90.1.0035
  8. Hadley MN, Spetzler RF, Sonntag VKH : The transoral approach to the superior cervical spine. A review of 53 cases of extradural cervicomedullary compression. J Neurosurg 71 : 16-23, 1989 https://doi.org/10.3171/jns.1989.71.1.0016
  9. Hall JE, Denis F, Murray J : Exposure of the upper cervical spine for spinal decompression by a mandible and tongue-splitting approach. Case report. J Bone Joint Surg 59A : 121-123, 1977
  10. Laus M, Pignatti G, Malaguti MC, Alfonso C, Zappoli FA, Giunti A : Anterior extraoral surgery to the upper cervical spine. Spine 21 : 1687- 1693, 1996 https://doi.org/10.1097/00007632-199607150-00015
  11. McAfee PC, Bohlman HH, Riley LH, Robinson RA, Southwick WO, Nachlas NE : The anterior retropharyngeal approach to the upper part of the cervical spine. J Bone Joint Surg 69A : 1371-1383, 1987
  12. McDonnell DE, Harrison SJ : Anterolateral cervical approach to the craniovertebral junction, in wilkins RH, Rengachary SS (eds) : Neurosurgery. New York, McGraw-Hill, 1996, Vol 2, ed 2, pp1641-1653
  13. Menezes AH, VanGilder JC : Transoral-transpharyngeal approach to the anterior craniocervical junction. Ten-year experience with 72 patients. J Neurosurg 69 : 895-903, 1988 https://doi.org/10.3171/jns.1988.69.6.0895
  14. Vender JR, Harrison SJ, McDonnel DE : Fusion and instrumentation at C1-3 via the high anterior cervical approach. J Neurosurg 92 : 24- 29, 2000 https://doi.org/10.3171/jns.2000.92.1.0001