By Professor Dr. med. Prof. h.c. Madjid Samii, Professor Dr. med. Engelbert Knosp (auth.)
A distinct type of ebook! The clivus of cranium base is a space tricky to arrive in neurosurgery, otorhinolaryngolo- gy, maxillo-facial surgical procedure, cosmetic surgery, reconstructive surgical procedure, and orthopedic surgical procedure. it really is as a result that many of the specialities gave discovered assorted methods for various operations.
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Additional info for Approaches to the Clivus: Approaches to No Man’s Land
If necessary, the styloid process is resected, which results in an extension into the parapharyngeal space. 4a-c. After incision of the dura, the vertebral junction (a) as well as the cranial (b) and contralateral boundaries (c) of the approach are exposed. B Basilar artery; /1;, left vertebral artery; v,:, hypoplastic right vertebral artery; black arrow, origin of anterior spinal artery. Right abducent nerve exposed with a nerve hook; white arrow, anterior inferior cerebellar artery; double arrow, root fibres of the hypoglossal nerve 28 Transcervical Approach displaced laterally.
Fluoroscopy is centered on the clivus from exactly laterally so the direction of approach and the positions of the instruments can be checked (Fig. 7). In the sublabial modification of this approach the mucous membrane of the nasal septum is infiltrated first and a sublabial incision performed. The lower limit of the nasal aperture is exposed. The mucous membrane is detached unilaterally from the cartilaginous septum, which is then transected at the transitional zone to the osseous septum and mobilized.
1979). 30 Advantages and Disadvantages For the reasons mentioned above, the transcervical approach is not only limited to extradural lesions, provided that they are located in the lower half of the clivus. Of course, the limitations only pertain to the clival extent: the entire cervical spine can be attained this way (Lesoin et al. 1986). The site of operation is laterally restricted, which is characteristic of all anterior approaches. Tracheostomy is recommended to achieve complete mandibular occlusion on the one hand and not to impede mobilization of the pharynx on the other hand (Stevenson et al.
Approaches to the Clivus: Approaches to No Man’s Land by Professor Dr. med. Prof. h.c. Madjid Samii, Professor Dr. med. Engelbert Knosp (auth.)