Transcondylar approach for resection of lateral medullary cavernous malformation.

ABSTRACT

BACKGROUND: Resection of a medullary cavernous malformation requires aggressive exposure, but there is controversy on how much occipital condyle can be safely removed during the transcondylar approach. METHOD: We describe and demonstrate the use of the transcondylar approach to a medullary cavernous malformation, with emphasis on adequate surgical exposure while preserving the atlanto-occipital joint. CONCLUSIONS: Despite conservative handling of the occipital condyle, craniocervical stability may vary in patients after transcondylar surgery. A "dynamic" computer tomography, with views of the atlanto-occipital joint at each end-rotational extreme, may be the best postoperative assessment tool to evaluate the stability of the craniocervical junction.