By John S. Oghalai, Colin L. W. Driscoll
Long awaited, this effective surgical atlas covers all elements of neuro-otology and lateral cranium base tactics in comprehensively intimately. The lavishly illustrated step by step advisor is written by means of American specialists to make sure continuity among themes. The textual content is extremely dependent with step by step rationalization of every surgery and suggestions and methods sections in addition to a PEARLS part in each one bankruptcy. greater than two hundred brilliant paintings illustrations describe each one surgery with approximately six hundred extra intraoperative photographs with CT and MRI photos to educate particular case examples. this provides a whole academic adventure for the cranium base medical professional in education and a radical reference for the skilled surgeon.
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Additional info for Atlas of Neurotologic and Lateral Skull Base Surgery
The skin, subcutaneous tissues, and periosteum are lifted off the skull, while the temporalis muscle is left in place. Care must be taken when elevating over the zygoma not to damage the frontal branch of the facial nerve. This nerve is preserved by lifting this plane deep to the superficial temporalis fascia prior to the midpoint of the zygoma and elevating posteriorly. This avoids injury to the temporal branch of the facial nerve as it transitions from deep to superficial in this area. Next, the periosteum along the underside of the superior edge of the zygoma is incised.
This is helpful in identifying the true posterior/medial edge of the petrous bone as there are often misleading false ridges. The arcuate eminence (AE) is a bulge that approximates the location of the superior semicircular canal. Dural elevation begins posteriorly, and the petrous ridge and superior petrosal sinus are identified first. 23 MMA GSPN FO AE SPS Dissecting medially and anteriorly will then permit identification of the GSPN as described. These two landmarks (the petrous ridge and the GSPN) should give you sufficient orientation to anticipate the location of all other structures.
71. A view after removing easily accessible extracranial tumor through the region of bone erosion. Note that we really like the use of the yellow fishhook retractors (sometimes called “Lone-Stars”) to hold the overlying soft tissues out of the way during skull base procedures. They are easy to reposition and do not require an assistant to reach into the operative field under the microscope to hold a retractor. 70. The temporalis muscle was then reflected inferiorly off the skull in a subperiosteal plane.