Transoral surgical approach for atlantoaxial cervical synovial cysts.

Sir, I read the recent publication on “Transoral Surgical Approach for Atlantoaxial Cervical Synovial Cysts (3)” with a great interest. Lyons and Birch concluded that “Surgical resection and decompression of the neural structures can be an effective treatment for symptomatic atlantoaxial synovial cysts (3).” Although the number of subjects in this work is limited, it can provide a useful contribution to the field. Indeed, the surgical approach usually results in a good outcome (2). However, the important point is the diagnosis. For sure, in the well-diagnosed cases, the treatment can be planned and success can be expected. However, in the hard-to-diagnose cases, the results might not be the same. The key point seems to be preoperative preparation rather than the operative technique (1). For sure, this retrospective study cannot avoid selection bias, and the conclusion on the effectiveness in this series therefore has to be carefully interpreted. references