Transoral Approach To C1-2

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