Neurosurgery

Atlas of Neurotologic and Lateral Skull Base Surgery by John S. Oghalai, Colin L. W. Driscoll

By John S. Oghalai, Colin L. W. Driscoll

Long awaited, this high quality surgical atlas covers all elements of neuro-otology and lateral cranium base methods in comprehensively intimately. The lavishly illustrated step by step advisor is written by way of American specialists to make sure continuity among subject matters. The textual content is very dependent with step by step rationalization of every surgery and assistance and methods sections in addition to a PEARLS part in every one bankruptcy. greater than 2 hundred wonderful art illustrations describe each one surgery with approximately six hundred extra intraoperative images with CT and MRI pictures to coach particular case examples. this provides a whole academic event for the cranium base health professional in education and an intensive reference for the skilled surgeon.

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In any case, expect dissection in this area to bleed. Once the dura can no longer be elevated anteriorly any further because of the foramen ovale, the bleeding should be controlled with hemostatic agents (such as Flowseal and Surgicel). A cottonoid should then be placed on top of it and left in place for the remainder of the case. By the time surgery is done, the cottonoid can be removed, and there is usually no further bleeding. The elevation of the dura needs to continue medially all the way to the petrous ridge, where the superior petrosal sinus (SPS) runs.

The dura is separated from the underside of the bone flap using an elevator. Care is taken to minimize this dissection in regions outside the bone flap as this raises the risk of a post-op epidural hematoma. Finally, a craniotome is used to turn the bone flap. The flap is placed in moist gauze or soaked in Bacitracin solution and saved on the back table until closing at the end of the procedure. EAC BH Approach to the Internal Auditory Canal 7. The dura is elevated off the temporal floor. This can be done with a Freer elevator, although we prefer the Joseph (narrow mastoid) elevator as it is stiffer.

Also, the tumor in the sphenoid sinus could be removed. Thus, the periorbita (P) and the sphenoid sinus mucosa (SS) are visible in this image. However, we did remove a bone flap over the temporal lobe in order to remove the intracranial portion of the tumor. We resected the dura at the base of the meningioma. While some of the dura could be closed primarily (stitches), there was exposed brain medially (brain) near the lateral edge of the cavernous sinus (CS). P SS Brain CS 48 73. Artificial dura (DuraGen) was used to cover the residual defect, and it was made watertight with a sealent (DuraSeal, the blue material).

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