硬膜外前床突切除术：学习者视角的技术细节
Extradural anterior clinoidectomy: Technical nuances from a learner's perspective.
作者信息
Mishra Shashwat, Leão Baltazar, Rosito Diego Mendez
机构信息
Department of Neurosurgery, Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Neurosurgery, Arkansas Neuroscience Institute, St. Vincent's Infirmary, Little Rock, AR 72205, USA.
出版信息
Asian J Neurosurg. 2017 Apr-Jun;12(2):189-193. doi: 10.4103/1793-5482.145544.
BACKGROUND
Extradural removal of the anterior clinoid process (ACP) is a crucial step in the proper surgical exposure of various pathologies in and around the central skull base. Since the pioneering description by Dolenc, the technique of extradural clinoidectomy has undergone several refinements in the light of improved understanding of microsurgical anatomy and maturation of neurosurgical techniques. Mastery of the surgical nuances involved in performing this surgical exercise will allow the young neurosurgeon to execute this step without undue reluctance and trepidation.
OBJECTIVE
This paper is an attempt to describe in detail, from a learner's viewpoint, the sequence of maneuvers involved in extradural removal of the ACP.
MATERIALS AND METHODS
The standard pterional approach and extradural anterior clinoidectomy was performed on four sides of two formalin fixed and latex injected cadaver heads. Important steps were photographed through the surgical microscope.
CONCLUSION
An accurate understanding of the microsurgical anatomy of this region and the surgical nuances relevant to extradural clinoidectomy helps simplify the complexity of this surgical step.
背景
硬膜外切除前床突（ACP）是充分手术暴露中央颅底及其周围各种病变的关键步骤。自多伦茨首次描述以来，鉴于对显微外科解剖的深入理解和神经外科技术的成熟，硬膜外前床突切除术技术已历经多次改进。掌握进行该手术操作所涉及的手术细微差别，将使年轻神经外科医生能够毫无顾虑和恐惧地执行这一步骤。
目的
本文试图从学习者的角度详细描述硬膜外切除前床突所涉及的操作步骤。
材料与方法
在两个用福尔马林固定并注入乳胶的尸体头部的四个侧面进行标准翼点入路和硬膜外前床突切除术。通过手术显微镜拍摄重要步骤。
结论
对该区域显微外科解剖以及与硬膜外前床突切除术相关的手术细微差别的准确理解有助于简化这一手术步骤的复杂性。
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