Transoral Approach to C1-2
- fiberoptic nasotracheal intubation & NG tube
- Mayfield head rest with head slightly extended
- cleanse oral cavity with clorhexidine
- preop ABx = IV Ancef & Flagyl
- landmark - anterior tubercle on atlas (ALL & longus colli muscles attached)
- inject posterior oropharynx with 1:200,000 epinephrine
- midline 3 cm vertical incision centered on anterior tubercle
- expose anterior arch subperiosteally
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