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

By John M. Tew, Harry R. Van Loveren

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

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The dural flap is then split in midsection to the level of the superior petrosal sinus. Clips are placed on the superior petrosal sinus. The sinus and tentorial dura are then incised toward a point posterior to the insertion of the trochlear nerve. The dura is then further split down the line of Kawase's triangle, exposing the contents of the upper posterior fossa. 73 Posterior Petrosal Approach The posterior petrosal approach consists of temporal craniotomy, suboccipital craniotomy, and posterior petrosectomy.

68 Using a diamond burr, the surgeon proceeds with dissection along the greater superficial nerve to expose the geniculate ganglion. The labyrinthine segment of the facial nerve marks the beginning of the internal auditory canal. 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.

67 The greater superficial petrosai nerve is sectioned near the facial hiatus to prevent traction injury to the geniculate ganglion while drilling is done in this area. The horizontal section of the petrous carotid artery is exposed using a highspeed drill with a diamond burr. Removal of the bone should not proceed to the posterior loop in order to prevent injury to the geniculate ganglion and cochlea. 68 Using a diamond burr, the surgeon proceeds with dissection along the greater superficial nerve to expose the geniculate ganglion.

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