scholarly journals The Extended Pterional Craniotomy: A Contemporary and Balanced Approach

2019 ◽  
Author(s):  
Benjamin K Hendricks ◽  
Aaron A Cohen-Gadol
Keyword(s):  
Virtual Reality ◽  
Skull Base ◽  
Multimedia Presentation ◽  
Normal Anatomy ◽  
3 Dimensional ◽  
Pterional Craniotomy ◽  
Balanced Approach ◽  
Skull Base Approach ◽  
Cranial Fossa ◽  
Surgical Corridor

Abstract Pterional craniotomy is the workhorse approach among cranial operative corridors. It is a highly flexible skull base approach that affords excellent exposure of the anterior cranial fossa, the circle of Willis, and the interpeduncular region. Its strategic use via dynamic retraction can obviate the need to use a more extensive skull base route, such as orbitozygomatic osteotomy, in select cases. The focus of the surgeon should be reaching the surgical target effectively while minimizing disruption of normal anatomy. In other words, the focus should be less on “how to get there” and more on “what to do when you are there.” This multimedia presentation summarizes an efficient execution of this route and its expansion and demonstrates the surgical corridor via 3-dimensional virtual reality models.

Combining Stereoscopic Video and Virtual Reality Simulation to Maximize Education in Lateral Skull Base Surgery

2020 ◽  
Vol 162 (6) ◽  
pp. 922-925 ◽  
Author(s):  
Samuel R. Barber ◽  
Saurabh Jain ◽  
Michael A. Mooney ◽  
Kaith K. Almefty ◽  
Michael T. Lawton ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Skull Base ◽  
Temporal Bone ◽  
Stereoscopic Video ◽  
3D Slicer ◽  
3 Dimensional ◽  
Desktop Virtual Reality ◽  
Computed Tomography Images ◽  
Lateral Skull Base ◽  
Hands On

Mastery of lateral skull base (LSB) surgery requires thorough knowledge of complex, 3-dimensional (3D) microanatomy and techniques. While supervised operation under binocular microscopy remains the training gold standard, concerns over operative time and patient safety often limit novice surgeons’ stereoscopic exposure. Furthermore, most alternative educational resources cannot meet this need. Here we present proof of concept for a tool that combines 3D-operative video with an interactive, stereotactic teaching environment. Stereoscopic video was recorded with a microscope during translabyrinthine approaches for vestibular schwannoma. Digital imaging and communications in medicine (DICOM) temporal bone computed tomography images were segmented using 3D-Slicer. Files were rendered using a game engine software built for desktop virtual reality. The resulting simulation was an interactive immersion combining a 3D operative perspective from the lead surgeon’s chair with virtual reality temporal bone models capable of hands-on manipulation, label toggling, and transparency modification. This novel tool may alter LSB training paradigms.

The Transcondylar Approach to Access Symptomatic Arachnoid Cysts of the Hypoglossal Canal

2017 ◽  
Vol 14 (2) ◽  
pp. E23-E25
Author(s):  
Jan-Karl Burkhardt ◽  
Christina Bal ◽  
Marian Christoph Neidert ◽  
Oliver Bozinov
Keyword(s):  
Skull Base ◽  
Clinical Presentation ◽  
Arachnoid Cysts ◽  
Hypoglossal Canal ◽  
Transcondylar Approach ◽  
Suboccipital Craniotomy ◽  
Skull Base Approach ◽  
Skull Base Anatomy ◽  
Surgical Corridor ◽  
Progressive Dysphagia

Abstract BACKGROUND AND IMPORTANCE A direct transcondylar approach to treat symptomatic arachnoid cysts of the hypoglossal canal has not yet been described in the literature. CLINICAL PRESENTATION Here, we present a skull base approach in 2 female patients (68 and 38 yr) with progressive dysphagia, dysarthria, half-sided weakness, and atrophy of the tongue due to an arachnoid cyst of the hypoglossal canal. After patient informed consent, both patients were successfully operated on without complications using a transcondylar approach, and their symptoms improved 3 mo after surgery; in both patients, resection of the cyst was confirmed using magnetic resonance imaging. Review of the literature revealed 4 surgically treated cases of hypoglossal cysts operated on through a paramedian suboccipital craniotomy from a medial to lateral surgical corridor. CONCLUSION This is the first description of the transcondylar surgical approach to safely operate on symptomatic arachnoid cysts located in the hypoglossal canal. The isolated transcondylar approach is useful in selective cases when the pathology is located within the hypoglossal canal only and the skull base anatomy allows a direct approach.

scholarly journals Cranial base strategies for resection of craniopharyngioma in children

2005 ◽  
Vol 18 (6) ◽  
pp. 1-9 ◽  
Author(s):  
James K. Liu ◽  
Chad D. Cole ◽  
John R. W. Kestle ◽  
Douglas L. Brockmeyer ◽  
Marion L. Walker
Keyword(s):  
Skull Base ◽  
Postoperative Morbidity ◽  
Hormone Replacement ◽  
Total Removal ◽  
Complete Excision ◽  
Skull Base Approach ◽  
Microsurgical Techniques ◽  
Microsurgical Resection ◽  
Surgical Corridor ◽  
Neurovascular Structures

The optimal treatment of craniopharyngioma in children remains a challenge. The use of complete excision to minimize recurrence continues to be controversial because of the risk of postoperative morbidity and death. Advances in skull base approaches, modern microsurgical techniques, neuroimaging, and hormone replacement therapy, however, have allowed safe gross- or near-total resection in the majority of cases. Total removal of these tumors, if possible, offers the best chance of cure for the patient. Although craniopharyngiomas are not strictly tumors of skull base origin, their intimate relationship with the neurovascular structures of this region often requires a skull base approach to maximize the surgical corridor and facilitate adequate microsurgical resection. In this review, the authors focus on commonly used skull base approaches for the surgical management of craniopharyngioma. They discuss the relative indications, advantages, disadvantages, and complications associated with each approach. Illustrative cases and intra-operative videos are presented.

Outcomes of Transzygomatic Middle Cranial Fossa Approach for Resection of Skull Base Tumors

2019 ◽  
Author(s):  
Nauman Manzoor ◽  
Silky Chotai ◽  
Robert Yawn ◽  
Reid Thompson ◽  
Alejandro Rivas
Keyword(s):  
Skull Base ◽  
Middle Cranial Fossa ◽  
Skull Base Tumors ◽  
Middle Cranial Fossa Approach ◽  
Cranial Fossa
Sign in / Sign up

Export Citation Format

Share Document