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Transoral surgery for craniovertebral junction anomaly is a challenging task for a neurosurgeon because it involves operating through a very constrained space and at greater depth. Dissection of posterior pharyngeal wall muscles from C1 and C2 can be facilitated by the use of monopolar cautery. Most of the conventional monopolar cautery attachments are either not long enough or can impede vision due to their thickness. Moreover, they are not insulated up to the tip, and hence can cause mucosal injury leading to delayed healing.

Modification of Penfield dissector as monopolar cautery point for transoral odontoidectomy