By John S. Oghalai, Colin L. W. Driscoll
Long awaited, this tremendous surgical atlas covers all features of neuro-otology and lateral cranium base techniques in comprehensively intimately. The lavishly illustrated step by step consultant is written by way of American specialists to make sure continuity among issues. The textual content is very established with step by step rationalization of every surgery and counsel and strategies sections in addition to a PEARLS part in every one bankruptcy. greater than 2 hundred exceptional art illustrations describe every one surgery with approximately six hundred extra intraoperative images with CT and MRI photographs to coach particular case examples. this provides an entire academic event for the cranium base medical professional in education and a radical reference for the skilled surgeon.
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Extra info for Atlas of Neurotologic and Lateral Skull Base Surgery
Thus, retractors can be removed from the field when they are not necessary. This decreases the risk of retraction injury to the brain and thrombosis of the sigmoid sinus. 4 Posterior Fossa Approaches 2. Overview of the bone to be removed (gray). Translabyrinthine Approach 3. The incision is ~2–3 cm behind the postauricular sulcus. It is further back than what is typically used for otologic surgery to permit removal of enough bone for adequate visualization. Although it is possible to use the same standard approach in all cases, there is value in considering each case individually and adapting your surgery to the particular challenges and opportunities presented.
The CSF space lateral to the tumor (between the tumor and the fundus) increases the chances of hearing preservation. 29 19. Intraoperative view during elevation of the temporal lobe dura in this patient. The instruments are directly over the epitympanum. Inferior Posterior Anterior Superior 18. Case 2: A right intracanalicular vestibular schwannoma appropriate for the middle fossa approach. 20. Dissection of the greater superficial petrosal nerve (GSPN). Note that a 1/2 in. square cottonoid kite (kite) is on top of the bleeding veins from around the foramen ovale and foramen spinosum.
The SCM is then taken down off the mastoid with cautery. For larger tumors, the digastric muscle is also taken out of its groove. 54 5. A simple mastoidectomy is performed with identification of the sigmoid sinus, the tegmen, the mastoid antrum, and the lateral semicircular canal. Only the antrum should be opened. The aditus ad antrum will need to be sealed with fascia at the conclusion of the procedure to prevent CSF leak, and it is easier to do this when the opening is small. Another option for this portion of the procedure is to remove the incus and open the superior part of the facial recess.
Atlas of Neurotologic and Lateral Skull Base Surgery by John S. Oghalai, Colin L. W. Driscoll