Approaches in Neurosurgery: Central and Peripheral Nervous - download pdf or read online

By I. Mohsenipour

ISBN-10: 0865775419

ISBN-13: 9780865775411

Universitatsklinik fur Neurochirurgie, Innsbruck, Austria. Atlas for neurosurgeons and citizens of techniques universal within the authors' neurosurgical practices. Descriptions contain positioning, wound closure, power error, and hazards. strange colour illustrations.

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Extra resources for Approaches in Neurosurgery: Central and Peripheral Nervous System

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63) The patient is placed in a supine position. As the positioning has to be very exact and needs to be steadily maintained (surgical microscope), the patient's head should be fixed in a three-pin head clamp that is firmly connected to the oper- Fig. 63 Rerional approach to the trontotemporal oase of the skull: positioning and incision 49 3 Approaches to the Frontotemporal Junction Dissection of Soft Tissues (Fig. 64) The skin flap is dissected from the superficial fascia of the temporal muscle by shallow advance of the scalpel blade and with the use of small, firm pledgets, and it is retracted with fishhooks.

62) In the next step, dura) elevation sutures extending around the circumference of the bone opening arc inserted, or elevation sutures are inserted and tied after the bone flap has been replaced, so as to minimize the chance of a spaceoccupying postoperative epidural hematoma developing. The bone flap can be readily fixed with dural elevation sutures that are likewise passed through the central bone. To this are added sutures between the temporal muscle, which has been reflected to its original position, and the, galea aponeurotica, transverse tension sutures possibly being used for reinforcement.

The skin incision either runs from posterior-superiortoward the lateral margin of the orbit and the zygomatic bone, or it takes the opposite course, that is, it curves above the lateral end of the eyebrow toward the temporal region, The latter incision usually gives better cosmetic results, but requires a somewhat larger approach. Special care should be taken to divide the skin so that the nerves and vessels of the next layer can be accessed under direct vision. The following figures show the posteriorly curved incision.

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Approaches in Neurosurgery: Central and Peripheral Nervous System by I. Mohsenipour

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