By Vinko V. Dolenc (auth.)
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Endoscopic neurosurgery has now not but reached the protection and applicability of microsurgery. Endo-neuro-sonography is a brand new procedure aimed toward making endoscopy more secure by means of real-time imaging and navigation potential (brain-radar). The endo-neurosonographic photograph is a sonographic test on the tip of the endoscope (mini-CT) offering more information to the endoscopic view.
The 1st point out of moyamoya disorder as a special affliction entity was once in a paper I released in 1965. The irregular internet like vessels on the base of the mind obvious in cerebral angio grams of this ailment have been defined through so much local audio system of eastern as "moyamoya," a jap expression for a few factor hazy, similar to a pant of cigarette smoke drifting within the air.
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Additional info for Microsurgical Anatomy and Surgery of the Central Skull Base
Further dissection of the specimen shown in Fig. 50. The proximal ring (PR) has been separated from nerve III, opening the parasellar space (PS) . The ICA segment between the PR and distal (dural) ring (OR) remains covered by the membrane between the leA and the inferomedial surface of the anterior clinoid process (ACP). The PR and the DR join at the posterior half of the base-line of the anteromedial triangle. The optic nerve (ON) dura propria has been incised, exposing the ophthalmic artery (OA) inferior and lateral to the ON as it courses toward the orbit through the optic canal.
Keeping the incision as close as possible to the tragus of the ear will avoid injury to the frontal branch of the facial nerve, the superficial temporal artery and vein, and the auriculotemporal nerve. The scalp flap is carefully separated from the periosteum and fascia of the TM, then reflected over the eye sufficiently far to expose the orbital rim where it joins the zygoma, then fixed anteriorly and laterally with fish hooks (Fig. 4a). Periosteum is incised in a curvilinear fashion, exposing frontal bone, the coronal suture, and the parietal bone while preserving the insertion of the TM.
The arterial supply of the PB capsule is provided by PS-ICA branches while the pituitary stalk is supplied by branches of the intradural ICA (Dawson's arteries) . PB hormones are released into the venous structures surrounding it. Tumors of the PS may extend into the sella and compress the PB, resulting in endocrine changes. Conversely, a PB tumor may compress or invade the parasellar space, creating symptoms and signs involving nerves III, IV, V1, V2, and VI. The relation of the PS to the sella is presented in Figs.