Download Atlas of operative microneurosurgery by John M. Tew, Harry R. Van Loveren PDF

By John M. Tew, Harry R. Van Loveren

Functional atlas of microscopic neurosurgery, for citizens and starting neurologic surgeons at the pathoanatomy of neurologic issues and their surgery. third-dimensional line drawings, a few with colour highlighting.

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The cortical bone of the superior semicircular canal forms a 50-degree angle with the internal auditory canal. Drilling anterior to the superior semicircular canal, the surgeon exposes the dural sleeve of the internal auditory canal. 70 The cortical bone overlying the cochlea is removed until the cochlea appears as a blue line in the junction between the carotid artery and the facial nerve. A line drawn from the tip of Bill's bar to the intersection of the carotid artery with the trigeminal nerve (Miller's line) approximates the basal turn of the cochlea.

Further removal of mastoid air cells exposes the fallopian canal, which runs from the digastric ridge to the antrum at approximately the same depth as the posterior semicircular canal. 83. 85 The dura between the sigmoid sinus and the petrous apex is exposed. A dural incision is made in the posterior fossa dura (inferior to the petrosal sinus) and in the middle fossa dura (superior to the sinus). 86 Clips are applied to the superior petrosal sinus. 87 The superior petrosal sinus and tentorium are incised ventrally toward the incisura in a course directed posterior to the trochlear nerve.

Addition of the retrosigmoid approach more generously exposes the posterior fossa and foramen magnum. A subtemporal approach combined with a retrosigmoid approach, in the absence of presigmoid dissection, places the vein of Labbe and the posterior temporal lobe in greater peril. 72 An armored endotracheal tube is inserted to avoid obstructing the airway when the patient's head is turned. Prior to positioning the patient, a catheter is inserted into the lumbar spinal canal for subsequent drainage of cerebrospinal fluid.

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