Transoral anterior approach using median mandibular splitting in upper spinal tumor extirpation.
OBJECTIVE
Transoral approach from the anterior direction is necessary if an upper spinal tumor is too big to extirpate via the posterior approach alone. To obtain a good anterior view of the surgical field, the mandible, tongue, and soft palate have to be split, and we developed a criterion to select the surgical strategy.


METHODS
We indicated a decision-making process of splitting techniques and indications with actual cases and review of literatures.


RESULTS
Tumors were located from the level of C1 to the lower part of C3. Computerized tomography and magnetic resonance imaging were important to decide approaches. The orthopedic surgical team invited oral and maxillofacial surgeons team to assist in all transoral anterior approach cases.


CONCLUSIONS
Vertical splitting of the mandible, incising the skin of the mental region, and splitting the middle of the tongue were combined according to the position of the spinal tumor.
Division of Oral and Maxillofacial Surgery, Department of Dentistry and Oral Surgery, School of Medicine, Keio University, Tokyo, Japan. kawana@z6.keio.jp
Kawana
K
Hiromasa
Kato
K
Shin
Asoda
A
Seiji
Koike
K
Akihiko
Iwasaki
I
Ryotaro
Matsumoto
M
Morio
Watanebe
W
Kota
Imanishi
I
Yorihisa
Ogawa
O
Kaoru
Nakagawa
N
Taneaki
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D013125:Spinal Neoplasms / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000379:methods*