By Francesco Tomasello (auth.), Paolo Cappabianca, Giorgio Iaconetta, Luigi Califano (eds.)
This atlas, prepared in sections -neurosurgical part and maxillo-facial part- presents a entire evaluation of the main glossy surgical innovations in cranio-facial and cranium base surgery.
Each bankruptcy describes intimately the anatomic buildings and gives a step by step description of the technical facets of the surgical ways to the cranial base.
Written through top specialists in cranial base surgical procedure and that includes various intraoperative images and surgical drawings, the quantity might be a really sensible and useful gizmo for citizens, surgeons and otolaryngologists.
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Extra info for Cranial, Craniofacial and Skull Base Surgery
Presented below are the steps that we follow supplemented with the modifications and suggestions of other groups (Figs. 3). The patient is placed supine with 20° of reverse Trendelenberg position to facilitate venous drainage. The head is positioned with 20° of neck extension to allow the frontal lobe to auto-retract. The degree of head rotation towards the contralateral side is determined by the location of the pathology. Ipsilateral lesions require less head rotation (15–30°) than lesions of the olfactory groove and tuberculum sella (45–60°).
The incision is carried to the lateral margin of the eyebrow. If necessary, it can be extended up to 1 cm lateral to this point with a cosmetically pleasing result. Lateral exposure must be sufficient to place the frontobasal burr hole. To maximize exposure, the skin edges are undermined. We prefer to incise the frontalis muscle in the line of the incision. Next, an inferiorly based U-shaped pericranial flap is incised and elevated. The margins of the skin incision are retracted with fish-hooks.
11 Intraoperative MRI Prior to opening the dura mater and whenever the surgeon thinks it is appropriate (especially while working very close to vascular structures), it is of utmost importance to use the microDoppler probe to insonate the major arteries . The use of such a device is recommended every time a sharp dissection is performed to minimize the risk of injury to either the carotid or the basilar artery or the other vascular structures that may be close to or even compressed by the lesion.