By MD S.James Zinreich, Donlin M. Long, John K. Niparko, Bert W. O'Malley Jr, S. James Zinrich, Daniel J. Lee
Operative techniques at once at the base of the mind, internal ear, and cranial nerves are inherently gentle undertakings, and are extra advanced by way of the trouble of accomplishing quick access to this limited area. that includes wide diagrams, illustrations, and images, this e-book comprehensively covers all the valuable surgical techniques to the bottom of the cranium. Written by means of pioneers operating at one of many world's best facilities for complicated neurosurgery, it basically describes the stairs wherein all the key anatomical buildings on the cranium base and internal ear will be accessed so one can practice complicated surgical interventions.
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Extra info for Atlas of Skull Base Surgery (The Encyclopedia of Visual Medicine Series)
Anterior osteotomies are made from the anterior crest of the lacrimal fossa to the nasion to define the anterior bony margins of tumor resection. Page 27 Figure 9 Facial osteotomies for extracranial tumor removal Upon completion of the facial dissection and osteotomies, there is good exposure of the tumor specimen from both above and below the skull base. At this point, osteotomies are made in the fovea ethmoidalis bilaterally to define the superolateral resection margins (Figure 10). Anterior osteotomies are made in the frontal sinus ducts or just anterior to the ducts, as needed to define the anterosuperior margins of resection.
For increased exposure in the infratemporal fossa, the coronoid process may be cut to improve the inferior rotation of the temporalis muscle. Excellent access to the infratemporal fossa is now achieved and the lateral pterygoid muscle may be detached from its bony skull base attachment or resected as needed. Wide exposure of the frontal, lateral temporal, and infratemporal skull base allows for craniotomy or craniectomy as needed for tumor resection (Figure 11). As each skull base tumor is different, the extent of exposure and tumor resection using the transfacial approach will vary for each individual case.
With Dr Nager’s urging, it became evident that the greatest advances in this complex surgical area could be made by organizing the overlapping specialties to take advantage of their diverse and unique skills. At the inception, the disciplines of Neurosurgery and Otology combined efforts. Neuro-ophthalmology followed and joined the team effort. Significant contributions and benefits from both diagnostic and interventional neuroradiology, dedicated neuroanesthesia, and a neurological intensive care team were readily recognized and incorporated into this ‘team’.