Soft-Tissue Dissection in Transcondylar Approach to Maximize Lateral Access: A Modified Layered Approach

Objective: The transcondylar approach is technically challenging but it provides ventral and caudal exposure at the cranio-vertebral junction, requiring navigation around multiple eloquent neurovascular structures including the hypoglossal nerve, vertebral artery and its branches, glossopharyngeal nerve, vagus nerve, and spinal accessary nerve, and the brainstem. Superficial exposure including incision design and muscle dissection can dramatically affect surgical angle and maneuverability at depth.