Surgery Of The Skull Base

The region of the skull base was long considered a surgical barrier because of its complex anatomy. With few exceptions, the region immediately beyond the dura or bony skull base constituted a "no man's land" for the surgeon working from the other direction. A major reason for this was the high morbidity associated with operative procedures in that area using traditional dissection techniques. This situation changed with the advent of the operating microscope. Used initially by ear, nose and throat specialists for resective and reconstructive surgery of the petrous bone and parana sal sinuses, the operating microscope was later introduced in other areas, and neurosurgeons began using it in the mid-1960s. With technical equality thus established, the groundwork was laid for taking a new, systematic, and interdisciplinary approach to surgical problems of the skull base. Intensive and systematic cooperation between ear, nose and throat surgeons and neurologic surgeons had its origins in the departments of the University of Mainz bindly supported by our chairmen Prof. Dr. Dr. hc Kurt Schiirmann (Department of Neurosurgery) and Prof. Dr. W. Kley (Depart ment of Ear, Nose and Throat Diseases, Head and Neck Surgery). The experience gained from this cooperation was taught in workshops held in Hannover from 1979 to 1986, acquiring a broader interdisciplinary base through the participation of specialists from the fields of anatomy, patholo gy, neuroradiology, ophthalmology, and maxillofacial surgery.

This book discusses all aspects of skull base surgery, from a neurosurgical point of view. The therapeutic options in the treatment of skull base lesions are explained and a systematic overview of relevant diseases is included. A strong emphasis is placed on practical aspects of skull base surgery: classic surgical approaches and also methods where there has been rapid recent development, such as stereotactic radiation therapy and interventional neuroradiology. Several international specialists systematically describe the treatment of traumatic lesions, tumors, vascular lesions, and developmental anomalies. Surgery of the Skull Base is aimed at neurosurgeons, ENT surgeons, maxillofacial surgeons, neurologists, and radiologists.

The essential multidisciplinary guide for the prevention and management of vascular injury from master skull base surgeons Vascular injury is the most significant source of morbidity or mortality during skull base surgery, regardless of the surgical approach. While skull base approaches always placed arteries and veins at risk, newer endoscopic endonasal approaches have introduced new challenges for the prevention and management of vascular injury. Greater anatomic knowledge, additional surgical options, improved instrumentation, advances in interventional neuroradiology, and enhanced training all contribute to successful outcomes. Vascular Challenges in Skull Base Surgery by renowned skull base experts Paul Gardner, Carl Snyderman, Brian Jankowitz, and distinguished contributors, fills a gap in the literature, with invaluable guidance on managing rare but potentially catastrophic surgical complications. The full range of surgical approaches to the anterior, middle, and posterior cranial fossae are covered in 22 chapters. Diverse topics encompass open and endoscopic endonasal surgical approaches, endovascular techniques including balloon test occlusion and embolization, and standard and alternative bypass procedures. The last three chapters discuss venous considerations, neurophysiologic monitoring, and the role of training and simulation in vascular injury prevention. Key learning points, illustrated discussion of relevant anatomy, and tips and tricks are targeted at helping skull base surgeons leverage practical strategies to improve patient outcomes. Key Highlights An impressive group of expert, highly-experienced surgeons share firsthand knowledge Insightful analyses of root causes and clinical pearls provide indispensable prevention tactics High-quality images and videos enhance visual understanding of surgical anatomy and techniques Trainees and practicing skull base surgeons will greatly benefit from the collective knowledge and evidence-based injury avoidance strategies shared by authors who have learned to master the art of skull base surgery.

Handbook of Skull Base Surgery is a state-of-the-art surgical guide that provides clinicians and surgeons with step-by-step instructions on how to perform microscopic and endoscopic procedures. Encompassing the entire skull base, this handbook is designed for busy residents and clinicians seeking to hone their surgical skills. It presents a multidisciplinary approach to the pathologies, diagnosis, and management of skull base lesions. Key Features: Bulleted format with step-by-step descriptions of procedures accompanied by high-quality illustrations of key points Succinct summaries of content enable readers to quickly obtain the information they need Includes coverage of relevant basic sciences, advanced imaging, and adjunctive treatments such as radiosurgery and chemotherapy Comprehensive yet conveniently compact, this book is a must-have reference for residents, clinicians, nurses and researchers caring for patients with skull base pathologies.

Unique skull-base surgical resource features strategic, technical, and philosophical pearls from master surgeons In a sense, surgeons go into battle every time they enter the OR. Like soldiers, they must be prepared to make profound sacrifices to protect innocent people (their patients), while putting egos aside and resisting the call of fame. Skull Base Surgery: Strategies by Walter Jean and distinguished contributors provides eloquent expression to the inner voices that speak to surgeons during each stage of battle. Unlike other textbooks that only emphasize the technical building blocks surgeons need, this resource focuses on state-of-the-art skull-base procedures, important thought processes, and vital strategies required to perform them. Size and shape variations, diverse biological characteristics, different anatomic locations and extensions, and specific relationships and entanglements with nerves and vessels make all skull base tumors unique and highly challenging. In addition to anatomy, two other important factors need to be considered every time a surgeon enters the OR - the particular circumstances of the patient and surgeon. Throughout this remarkable book, master neurosurgeons take readers on an insightful journey exploring the decision-making process of choosing and executing a surgical approach, with firsthand pearls from the battlefield. Key Highlights Nine sections organized by anatomy cover tumors in the anterior, anterolateral, lateral, central, postero-superior, and postero-inferior skull base regions, and clivus, petrous bone, and ventricles Thirty-two systematically organized chapters flow from clinical presentation and radiographic/anatomical findings of specific patients and tumors - to decision-making and execution of the surgical approach Real-life cases enhance understanding of all the elements that go into each operation Perspectives sections at the end of each chapter embrace the concept of diverse surgeon viewpoints on similar ideas, techniques, and approaches This exemplary book is essential reading for neurosurgery and otolaryngology residents, fellows, veteran practitioners, and allied health personnel who care for patients with skull base tumors. This book includes complimentary access to a digital copy on https://medone.thieme.com.

Unique skull-base surgical resource features strategic, technical, and philosophical pearls from master surgeons In a sense, surgeons go into battle every time they enter the OR. Like soldiers, they must be prepared to make profound sacrifices to protect innocent people (their patients), while putting egos aside and resisting the call of fame. Skull Base Surgery: Strategies by Walter Jean and distinguished contributors provides eloquent expression to the inner voices that speak to surgeons during each stage of battle. Unlike other textbooks that only emphasize the technical building blocks surgeons need, this resource focuses on state-of-the-art skull-base procedures, important thought processes, and vital strategies required to perform them. Size and shape variations, diverse biological characteristics, different anatomic locations and extensions, and specific relationships and entanglements with nerves and vessels make all skull base tumors unique and highly challenging. In addition to anatomy, two other important factors need to be considered every time a surgeon enters the OR – the particular circumstances of the patient and surgeon. Throughout this remarkable book, master neurosurgeons take readers on an insightful journey exploring the decision-making process of choosing and executing a surgical approach, with firsthand pearls from the battlefield. Key Highlights Nine sections organized by anatomy cover tumors in the anterior, anterolateral, lateral, central, postero-superior, and postero-inferior skull base regions, and clivus, petrous bone, and ventricles Thirty-two systematically organized chapters flow from clinical presentation and radiographic/anatomical findings of specific patients and tumors – to decision-making and execution of the surgical approach Real-life cases enhance understanding of all the elements that go into each operation Perspectives sections at the end of each chapter embrace the concept of diverse surgeon viewpoints on similar ideas, techniques, and approaches This exemplary book is essential reading for neurosurgery and otolaryngology residents, fellows, veteran practitioners, and allied health personnel who care for patients with skull base tumors.

Although surgery of the skull base still represents a frontier involving different specialties, it is increasingly being accepted and recognized as a special area po sing both unique diagnostic and surgical challenges and specific requirements. This is the prime reason that colleagues involved in the management of skull base processes need special training stressing the different surgical approaches required either at different times or to reach the different areas of this intriguing anatomi cal landmark. Although the advent of microsurgical techniques and advanced diagnostic mo dalities - high-resolution computed tomography, magnetic resonance imaging (MRI) and MR-angiography, and supers elective endovascular protocols - in the last 25 years has brought significant improvements, such as the recent advances in endovascular treatment, a number of different kinds of limitations still persist. This is especially so in the case of skull base meningiomas, the pathological entity most frequently affecting this area which the neurosurgeon is confronted with in daily practice. Besides understanding the intrinsic characteristics of the different pathological entities which involve the skull base, it is the responsibility of physi cians to know and employ the expanded neurosurgical options in the most effecti ve and appropriate way.

Handbook of Skull Base Surgery is a state-of-the-art surgical guide that provides clinicians and surgeons with step-by-step instructions on how to perform microscopic and endoscopic procedures. Encompassing the entire skull base, this handbook is designed for busy residents and clinicians seeking to hone their surgical skills. It presents a multidisciplinary approach to the pathologies, diagnosis, and management of skull base lesions. Key Features: Bulleted format with step-by-step descriptions of procedures accompanied by high-quality illustrations of key points Succinct summaries of content enable readers to quickly obtain the information they need Includes coverage of relevant basic sciences, advanced imaging, and adjunctive treatments such as radiosurgery and chemotherapy Comprehensive yet conveniently compact, this book is a must-havereference for residents, clinicians, nurses and researchers caring for patients with skull base pathologies.