title: Enlarged approach to the anterior cervical spine.
abstract: In this report a new enlarged approach to the anterior cervical spine is presented. A 66-year-old female, having a large C3-C4-C5 chordoma, recurrent after surgery and following radiotherapy, underwent a surgical resection. The approach allows a wide retraction of the nasopharynx, oropharynx and larynx from the midline, only sacrificing the superior laryngeal nerve on one side. Its continuity can be re-established later by adopting the stent in tube technique. The approach we used presents all the risks of infection common in trans-oral approaches. For this reason, closure of the pharynx in two layers must be meticulous and watertight and reinforced by using a myofascial sternocleidomastoid flap, according to the tracheoesophageal fistula closure technique. A correct alignment of the tongue, the pre-plating of the mandible and the correct suture of the vermillion border guarantee excellent cosmetic and functional results.
authors.affiliation: Department of ENT I, University of Turin, Italy giovannisucco@hotmail.com
authors.forename: G
authors.initials: G
authors.lastname: Succo
authors.forename: A
authors.initials: A
authors.lastname: Solini
authors.forename: E
authors.initials: E
authors.lastname: Crosetti
authors.forename: G
authors.initials: G
authors.lastname: Gargiulo
authors.forename: A
authors.initials: A
authors.lastname: Sartoris
mesh_terms: D000368:Aged; D002574:Cervical Vertebrae; D002817:Chordoma / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000379:methods*; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome