Transoral Versus Transnasal Approach for Craniovertebral Junction Pathologies: Never Say Never.

For many years, the microsurgical transoralapproach (TOA) has been accepted as the“gold standard”for the surgical treatment of a variety of congenital,developmental, and acquired pathologies affecting thecraniovertebral junction. In the present study, we try toinvestigate both experimental and clinical fronts of such achallenging surgery, starting from the updated literatureexperience. TOA is actually presented as an“old-fash-ioned”surgical technique dealing with possible bacterialcontamination, the need of postoperative nose gastric tubefeeding for a week, the possible nasopharyngeal incom-petence, and the postoperative tongue swelling. Other-wise, the endoscopic endonasal approach (EEA) appearsstrongly supported by the mo