"A deep knowledge of regional anatomy, improved understanding of pathologies and their behaviors, technological advances, and multidisciplinary collaboration have led to more effective treatments for the once inoperable skull base lesions. Microsurgical and Endoscopic Approaches to the Skull Base: Anatomy, Tactics, and Techniques by renowned skull base neurosurgeons Luis A. B. Borba and Jean G. de Oliveira presents a balanced, anatomy-based perspective on microsurgical and endoscopic approaches to manage these highly challenging lesions. The text leverages the best current scientific literature on this topic and insights from global skull base surgery experts"--.

• Microsurgical and Endoscopic Approaches to the Skull Base: Anatomy, Tactics, and Techniques
• MedOne Access Information
• Title
• Copyright
• Contents
• Videos
• Foreword
• Preface
• Acknowledgment
• Contributors
• Section I Instrumentals and Equipment
  • 1 Instrumentation for Endoscopic Skull Base Surgery
    • 1.1 Introduction
    • 1.2 Special Requirements for Endoscopic Approaches
    • 1.3 Patient Positioning and Operating Room Setup
      • 1.3.1 Positioning
      • 1.3.2 Operating Room Setup
    • 1.4 Endoscopes and Video Systems
      • 1.4.1 Types of Endoscopes: Function and Management
      • 1.4.2 Irrigation Sheaths and Pumps
      • 1.4.3 Pneumatic Holding Arms
      • 1.4.4 Light Sources
      • 1.4.5 High-Definition Digital Cameras and Monitors
    • 1.5 Surgical Instruments
      • 1.5.1 Microdrills Handpieces and Burrs
      • 1.5.2 Microinstruments, Dissectors, and Micro-Ultrasonic Aspirator (microCUSA)
    • 1.6 Neuromonitoring and Neuronavigation in Endoscopic Skull Base Surgery
    • 1.7 Conclusion
    • References
  • 2 Neurosurgical Instrumentation
    • 2.1 Operating Room
    • 2.2 Microscope
    • 2.3 Neuroendoscopy
    • 2.4 Patient Positioning
    • 2.5 Instruments
      • 2.5.1 Bipolar Coagulator
      • 2.5.2 Scissors
      • 2.5.3 Dissectors
      • 2.5.4 Needle, Suture, and Needle Holder
      • 2.5.5 Brain Retractor
      • 2.5.6 Suction
      • 2.5.7 Drills
      • 2.5.8 Tissue Forceps
      • 2.5.9 Aneurysm and Vascular Clips
    • References
  • 3 Neurophysiological Monitoring in Skull Base Surgery
    • 3.1 Introduction
    • 3.2 Electromyography (EMG)
      • 3.2.1 Background
      • 3.2.2 Cranial Nerves III, IV, and VI
      • 3.2.3 Cranial Nerve V
      • 3.2.4 Cranial Nerve VII
      • 3.2.5 Cranial Nerves IX, X, and XII
      • 3.2.6 Cranial Nerve XI
    • 3.3 Brainstem Auditory Evoked Potential (BAEP)
    • 3.4 Visual Evoked Potential (VEP)
    • 3.5 Cases
      • 3.5.1 Case 1
      • 3.5.2 Case 2
      • 3.5.3 Case 3
    • 3.6 Conclusion
    • References
• Section II Anterior Approaches Transnasal and Transoral
  • 4 Anatomical Landmarks of Anterior Approaches: An Endoscopic View
    • 4.1 Introduction
    • 4.2 Nasal Cavity
    • 4.3 Anatomy of the Transshpenoidal, Transtuberculum, and Transplanum Approaches
    • 4.4 Anatomy of the Transethmoidal Transcribriform Approach
    • 4.5 Anatomy of the Transclival and Craniovertebral Junction Approaches
    • 4.6 Anatomy of the Transpterygoid and Infratemporal Approaches
    • References
  • 5 Direct Microscopic Transsphenoidal Surgery with Hybrid Use of Endoscopy
    • 5.1 Introduction
    • 5.2 Direct Endonasal Microscopic TSS with Hybrid Use of Endoscopy
      • 5.2.1 Patient Preparation
      • 5.2.2 Endonasal Stage I
      • 5.2.3 Sphenoid Sinus Stage II
      • 5.2.4 Intrasellar Stage III
      • 5.2.5 Suprasellar Stage IV
      • 5.2.6 Hybrid Use of Endoscopy
      • 5.2.7 Closure
    • 5.3 Conclusion
    • References
  • 6 The Extended Transsphenoidal Approach (Mid-maxillotomy) to the Clivus
    • 6.1 Introduction
    • 6.2 Anatomical Background
    • 6.3 Indications
    • 6.4 Surgical Technique
    • 6.5 Patient Positioning
    • 6.6 Incision and Soft Tissues Dissection
    • 6.7 Osteotomy
    • 6.8 Nasal Dissection and Clivus Stage
    • 6.9 Closure
    • References
  • 7 The Microsurgical Transoral Approach
    • 7.1 Introduction
    • 7.2 Anatomy of the Craniovertebral Junction
    • 7.3 Indications
    • 7.4 Preoperative Evaluation
    • 7.5 Operative Technique
    • 7.6 Endoscopic Endonasal Approach
    • 7.7 Postoperative Care and Complications
    • 7.8 Conclusion
    • References
  • 8 Elongated and Pediculated Pericranial Flap for Endonasal Reconstruction of the Entire Ventral Skull Base
    • 8.1 Background
    • 8.2 Introduction
    • 8.3 Objective
    • 8.4 Methods
    • 8.5 Surgical Technique
    • 8.6 Results
    • 8.7 Discussion
    • 8.8 Conclusion
    • References
  • 9 Expanded Endoscopic Endonasal Approaches to the Sellar and Parasellar Regions
    • 9.1 Introduction
    • 9.2 Endoscopic Anatomy of the Sellar and Parasellar Regions
      • 9.2.1 Anterior Skull Base
      • 9.2.2 Sellar and Parasellar Regions
      • 9.2.3 Clival Region and Posterior Skull Base
    • 9.3 Surgical Technique, Technical Nuances, and Complications
      • 9.3.1 Trans-sellar Approach
      • 9.3.2 Transtuberculum Transplanum
      • 9.3.3 Trans-cavernous and Trans-clival (Superior Third)
    • 9.4 Illustrative Cases
      • 9.4.1 Case 1
      • 9.4.2 Case 2
    • 9.5 Conclusion
    • References
  • 10 The Endoscopic Transpterygoid Approach to the Parasellar and Infratemporal Fossa
    • 10.1 Introduction
    • 10.2 Anatomical Landmarks and Surgical Strategies
      • 10.2.1 Zone 1: Medial Petrous Apex (Infrapetrous)
      • 10.2.2 Zone 2: Petroclival Approaches (Infrapetrous)
      • 10.2.3 Zone 3: Inferior Cavernous Sinus and Quadrangular Space (Suprapetrous)
      • 10.2.4 Zone 4: Superior Portion of the Cavernous Sinus (Suprapetrous)
      • 10.2.5 Zone 5: Transpterygoid Infratemporal Approach (Suprapetrous)
    • 10.3 Limits of the Approach
    • 10.4 Conclusion
    • References
  • 11 Endoscopic Endonasal Transclival Approach to the Posterior Fossa
    • 11.1 Introduction
      • 11.1.1 Extradural Lesions
      • 11.1.2 Intradural Lesions
    • 11.2 Anatomy
    • 11.3 Tactics and Techniques
      • 11.3.1 Imaging
      • 11.3.2 Technical Approach
      • 11.3.3 Skull Base Reconstruction
    • 11.4 Conclusions
    • References
• Section III Surgical Approaches to the Orbit
  • 12 Microsurgical Anatomy of the Orbit
    • 12.1 Historical Account
    • 12.2 The Rule of Seven of the Orbit
    • 12.3 Orbital Bones
    • 12.4 Orbital Muscles and Vessels
    • 12.5 Orbital Nerves
    • 12.6 Topographical Relationships and Orbital Surgical Approaches
    • 12.7 Conclusion
    • References
  • 13 Lateral Orbitotomy Approach to the Orbit and Cavernous Sinus
    • 13.1 Historical Background
    • 13.2 Relevant Surgical Anatomy
    • 13.3 Indications
    • 13.4 Surgical Technique
    • 13.5 Advantages and Disadvantages
    • 13.6 Surgical Outcome and Complications
    • 13.7 Illustrative Cases
      • 13.7.1 Case 1: Cavernous Sinus Lesion Biopsy
      • 13.7.2 Case 2: SOF Lesion Removal
      • 13.7.3 Case 3: Temporal Pole Tumor Removal
    • 13.8 Conclusion
    • References
  • 14 Transcranial Approaches to the Orbit
    • 14.1 Historical Background
    • 14.2 Relevant Surgical Anatomy of the Orbit
      • 14.2.1 Structure of the Orbit
      • 14.2.2 Nerves of the Orbit
      • 14.2.3 Blood Supply to the Orbit
      • 14.2.4 Muscles of the Orbit
      • 14.2.5 Lacrimal Gland
    • 14.3 Indications for Transcranial Approaches to the Orbit
    • 14.4 Surgical Techniques
      • 14.4.1 Preoperative Preparation
      • 14.4.2 The Subfrontal Route
      • 14.4.3 The Supraorbital Route
      • 14.4.4 The Frontotemporal Approach
      • 14.4.5 The Superolateral Approach
    • 14.5 General Considerations to Avoid Postoperative Complications
      • 14.5.1 Nasal Sinuses
      • 14.5.2 Orbital Fat
      • 14.5.3 Brain Retraction
      • 14.5.4 Reconstruction of Orbital Walls
    • 14.6 Illustrative Cases
      • 14.6.1 Case 1: Cavernous Hemangioma of the Superomedial Orbital Quadrant
      • 14.6.2 Case 2: Recurrent Pleomorphic Adenoma of the Lacrimal Gland with Intracranial Extension
      • 14.6.3 Case 3: Meningioma of the Lateral Orbit
    • 14.7 Conclusion
    • References
  • 15 The Medial Endoscopic Approach to the Orbit
    • 15.1 Introduction
    • 15.2 Materials and Methods
    • 15.3 Surgical Technique
    • 15.4 Illustrative Cases
      • 15.4.1 Case 1
      • 15.4.2 Case 2
    • 15.5 Discussion
    • 15.6 Conclusion
    • References
• Section IV Anterior Approaches to the Skull Base
  • 16 Microsurgical Anatomy of the Anterior Skull Base Through a Cranial View
    • 16.1 Bony Anatomy
    • 16.2 Neurovascular Relationships
    • 16.3 Orbit
    • References
  • 17 Microsurgical Anatomy of the Anterior Skull Base as Seen Through the Endonasal Endoscopic View
    • 17.1 History
    • 17.2 Guiding Principles in Ventral Skull Base Surgery
    • 17.3 Microsurgical Anatomy of the Anterior Cranial Base
    • 17.4 Endocranial Surface of the Anterior Cranial Base: Overview
    • 17.5 Sinonasal Anatomy
      • 17.5.1 The Outer Circumferential-Radial Corridor Overview
    • 17.6 Anatomy from Frontal Sinus to Planum Sphenoidale (Transcribriform Corridor)
      • 17.6.1 Outer Circumferential-Radial Corridor
      • 17.6.2 Inner Circumferential-Radial Corridor (ICRC)
    • 17.7 Anatomy from Planum to the Superior Edge of the Sella (Transtuberculum/Transplanum Corridor)
      • 17.7.1 Outer Circumferential-Radial Corridor (OCRC)
      • 17.7.2 Inner Circumferential-Radial Corridor (ICRC)
    • 17.8 Anatomy of the Orbit (Transorbital Corridor)
      • 17.8.1 Outer Circumferential-Radial Corridor (OCRC)
      • 17.8.2 Inner Circumferential-Radial Corridor (ICRC)
    • 17.9 Conclusion
    • Suggested Readings
  • 18 Eyebrow Supraorbital Approach for Skull Base Lesions
    • 18.1 History of Supraorbital Craniotomy
    • 18.2 Relevant Surgical Anatomy
    • 18.3 Anatomical Limitations and Surgical Applications
    • 18.4 Surgical Technique
      • 18.4.1 Positioning and Anesthesia
      • 18.4.2 Skin Incision
      • 18.4.3 Craniotomy
      • 18.4.4 Intradural Dissection
      • 18.4.5 Closure
    • 18.5 Advantages and Disadvantages
    • 18.6 Illustrative Cases
      • 18.6.1 Case 1
      • 18.6.2 Case 2
    • 18.7 Conclusion
    • References
  • 19 Transbasal/Transcranial Microsurgical Approaches to Anterior Fossa Meningiomas
    • 19.1 Introduction
    • 19.2 Incidence
    • 19.3 Clinical Features
      • 19.3.1 Tuberculum Sellae Meningiomas
      • 19.3.2 Olfactory Groove Meningiomas
      • 19.3.3 Anterior Fossa Floor Meningiomas
    • 19.4 Diagnostic Imaging
      • 19.4.1 Skull Radiography
      • 19.4.2 Digital Subtraction Angiography of the Internal Carotid Artery
      • 19.4.3 Computed Tomography (CT)
      • 19.4.4 Magnetic Resonance Imaging (MRI)
    • 19.5 Surgical Treatment
    • 19.6 Surgical Approaches
    • 19.7 Preoperative Assessment
    • 19.8 Anesthesia
    • 19.9 Surgical Technique for the Approach of Tuberculum Sellae Meningiomas
      • 19.9.1 Positioning
      • 19.9.2 Frontotemporal Craniotomy with Resection of the Supraorbital Rim
      • 19.9.3 Lateral Fissure Splitting
      • 19.9.4 Tumor Resection
      • 19.9.5 Optic Nerves and Chiasm
      • 19.9.6 Arterial Dissection
      • 19.9.7 Pituitary Stalk
      • 19.9.8 Invasion of the Optic Canal and the Cavernous Sinus
      • 19.9.9 Tumor Implantation
      • 19.9.10 Closure
    • 19.10 Surgical Technique for the Approach to Olfactory Groove Meningiomas
      • 19.10.1 Positioning
      • 19.10.2 Bifrontal Craniotomy
      • 19.10.3 Dura Mater Incision
      • 19.10.4 Tumor Resection
      • 19.10.5 Arterial Dissection
      • 19.10.6 Optic Nerves and Chiasm
      • 19.10.7 Tumor Implantation
      • 19.10.8 Closure
      • 19.10.9 Subcranial Approach
    • 19.11 Surgical Technique for the Approach to Meningiomas of the Anterior Fossa Floor
    • 19.12 Postoperative Care
    • 19.13 Results
    • 19.14 Visual Outcome
    • 19.15 Complications
    • 19.16 Damage to the Pituitary Stalk
    • 19.17 Surgical Approach
    • 19.18 Retraction of Brain Tissue
    • 19.19 Damage to Vessels Close to the Tumor
    • 19.20 Mortality
    • References
  • 20 Orbitocranial Approach
    • 20.1 Introduction
      • 20.1.1 Historical Background
      • 20.1.2 Indications
    • 20.2 Surgical Technique
      • 20.2.1 Position
      • 20.2.2 Skin Incision
      • 20.2.3 Scalp Elevation
      • 20.2.4 Craniotomy
      • 20.2.5 Removal of the Orbital Rim
      • 20.2.6 Reconstruction
    • 20.3 Cases
      • 20.3.1 Case 1
      • 20.3.2 Case 2
    • References
  • 21 The Extended Endoscopic Endonasal Approach to the Anterior Fossa
    • 21.1 Introduction
    • 21.2 Surgical Approaches
      • 21.2.1 The Transplanum Transtuberculum approach
      • 21.2.2 Surgical Technique - Transplanum Transtuberculum Approach
      • 21.2.3 The Transcribriform Approach
      • 21.2.4 Surgical Technique Transcribriform Approach
      • 21.2.5 Reconstruction
    • 21.3 Clinical Cases
    • 21.4 Conclusion
    • References
• Section V Anterolateral Approaches
  • 22 Microsurgical Anatomy of the Cavernous Sinus
    • 22.1 Introduction
    • 22.2 The Sinus
    • 22.3 Osseous Relationships
    • 22.4 Nerves
    • 22.5 Ligaments
    • 22.6 Internal Carotid Artery and Branches
    • 22.7 Venous Compartments
    • 22.8 Cavernous Sinus Triangles
      • 22.8.1 Clinoidal Triangle
      • 22.8.2 Oculomotor Triangle
      • 22.8.3 Supratrochlear Triangle
      • 22.8.4 Infratrochlear Triangle (Parkinson’s Triangle)
    • 22.9 Middle Fossa and Paraclinoid Triangles
      • 22.9.1 Anteromedial Triangle
      • 22.9.2 Anterolateral Triangle
      • 22.9.3 Posterolateral Triangle (Glasscock’s Triangle)
      • 22.9.4 Posteromedial Triangle (Kawase’s Triangle)
      • 22.9.5 Paraclival Triangles
    • References
  • 23 Transcavernous Approach
    • 23.1 Introduction
      • 23.1.1 Anatomy of the Cavernous Sinus and Temporal Fossa
      • 23.1.2 Triangles of the Cavernosus Sinus
      • 23.1.3 Triangles of the Middle Fossa
    • 23.2 The Pretemporal Craniotomy
      • 23.2.1 Positioning
      • 23.2.2 Trichotomy
      • 23.2.3 Incision
      • 23.2.4 The Temporal Muscle
    • 23.3 Craniotomy
      • 23.3.1 The Exposure of the Lateral Wall of the Cavernous Sinus
      • 23.3.2 The Anterior Clinoid
      • 23.3.3 The Meckel’s Cave
      • 23.3.4 Anterior Petrosectomy
      • 23.3.5 Posterior Clinoid
    • 23.4 Discussion
    • References
  • 24 Microsurgical Anatomy of the Middle Fossa and Petrous Apex
    • 24.1 Background
    • 24.2 Anatomy
      • 24.2.1 Endocranial Surface and Its Limits
      • 24.2.2 The Foramens of the Middle Fossa
      • 24.2.3 Petrous Apex
    • 24.3 The Middle Fossa as a Surgical Corridor
    • 24.4 Cases
      • 24.4.1 Case 1
      • 24.4.2 Case 2
      • 24.4.3 Case 4
    • 24.5 Conclusions
    • References
  • 25 Pterional Approach
    • 25.1 Introduction
    • 25.2 Historical Landmarks
    • 25.3 Indications
    • 25.4 Step-by-Step Procedure
      • 25.4.1 Positioning
      • 25.4.2 Trichotomy
      • 25.4.3 Skin Incision
      • 25.4.4 Interfascial Dissection
      • 25.4.5 Temporal Muscle Dissection
      • 25.4.6 Craniotomy
      • 25.4.7 Sphenoid Wing Drilling
      • 25.4.8 Dural Opening
      • 25.4.9 Neurosurgical Routes
      • 25.4.10 Dural Closure
      • 25.4.11 Cranioplasty
      • 25.4.12 Muscle Reconstruction
      • 25.4.13 Variations
    • 25.5 Conclusion
    • 25.6 Illustrative Cases
    • References
  • 26 Anterolateral Skull Base: Anatomy, Surgical Technique, and Nuances
    • 26.1 Surgical Anatomy
      • 26.1.1 Sagittal and Axial Unlocking: A Wider Exposure to Skull Base
    • 26.2 Extended Skin Incision and Craniotomy
    • 26.3 Orbitomeningeal Band Dissection
    • 26.4 Pericavernous Dissection Techniques
    • 26.5 Anterior Clinoidectomy
    • 26.6 Posterior Clinoidectomy
    • 26.7 Petrous Anatomy and Anterior Petrosectomy
    • 26.8 Carotid Anatomy and Relations
    • References
  • 27 Pretemporal Approach
    • 27.1 Introduction
    • 27.2 Advantages of the Pretemporal Approach
    • 27.3 Anatomical Exposure and Surgical Access
    • 27.4 Indications
    • 27.5 Step-by-Step Procedure
      • 27.5.1 Patient Positioning
      • 27.5.2 Skin Incision
      • 27.5.3 Preservation of the STA
      • 27.5.4 Facial Nerve Branches Preservation
      • 27.5.5 Mobilization of the Temporal Muscle
      • 27.5.6 Craniotomy
      • 27.5.7 Variations and Alternative Routes
    • 27.6 Microsurgical Access to the Interpeduncular Fossa Region
    • 27.7 Conclusion
    • 27.8 Illustrative Cases
    • References
  • 28 Cranio-Orbit-Zygomatic (COZ) Approach
    • 28.1 Background
    • 28.2 Indications
    • 28.3 Technique
      • 28.3.1 Positioning
      • 28.3.2 Skin Incision and Pericranial Flap
      • 28.3.3 Subfascial Dissection
      • 28.3.4 Zygomatic Osteotomy
      • 28.3.5 Mobilizing the Temporal Muscle
    • 28.4 Craniotomy
      • 28.4.1 Cranial Flap
      • 28.4.2 Orbital Osteotomy
    • 28.5 Closure
    • 28.6 Limitations
    • 28.7 Complications and Avoidance
    • 28.8 Illustrative Cases
    • 28.9 Conclusions
    • References
  • 29 Anterior Petrosal Approach
    • 29.1 Introduction
      • 29.1.1 Anatomical Background
      • 29.1.2 Indications
    • 29.2 Surgical Technique
      • 29.2.1 Patient Positioning
      • 29.2.2 Skin Incision and Soft Tissue Dissection
      • 29.2.3 Zygomatic Osteotomy
      • 29.2.4 Temporalis Muscle Reflection
      • 29.2.5 Craniotomy
      • 29.2.6 Middle Fossa Dissection
      • 29.2.7 Closure
      • 29.2.8 Complications
    • References
  • 30 Endoscopic Approach to the Cavernous Sinus Area: Surgical Technique
    • 30.1 Introduction
    • 30.2 Technical Equipment and Surgical Supplies
    • 30.3 Preoperative Preparation Stage
      • 30.3.1 Setup of the Patient and the Surgeon
    • 30.4 Surgical Technique
      • 30.4.1 Stages of the Surgical Procedure
    • 30.5 A Clinical Case
    • 30.6 Perspectives
    • References
• Section VI Posterolateral Approaches
  • 31 Temporal Bone Anatomy
    • 31.1 Introduction
    • 31.2 Surgical Anatomy
      • 31.2.1 The Squamous Portion
      • 31.2.2 The Tympanic and Styloid Portions
      • 31.2.3 The Mastoid Portion
      • 31.2.4 The Petrous Portion
    • 31.3 Craniotopographic Relationships
    • Suggested Readings
  • 32 Microsurgical Anatomy of the Jugular Foramen
    • 32.1 Introduction
    • 32.2 Anatomy
    • 32.3 Bone and Osseous Relations
    • 32.4 Meningeal Structure and Cranial Nerves
    • 32.5 Vascular Structures Related to the Jugular Foramen
    • 32.6 Muscular Relationships
    • 32.7 Conclusions
    • References
  • 33 Anatomy of the Cerebellopontine Angle: A Microscopic Perspective
    • 33.1 A Brief Historical Review
    • 33.2 A Brief Introduction to the Anatomy of the CPA: A Detailed Look
    • 33.3 Surgical Anatomy of the CPA Region
      • 33.3.1 Continent: Walls of the CPA
      • 33.3.2 Content: The Neurovascular Complexes
    • References
  • 34 The Posterior Retrolabyrinthine Presigmoid Approach
    • 34.1 Background
    • 34.2 Indications
    • 34.3 Surgical Technique
      • 34.3.1 Patient Positioning
      • 34.3.2 Soft Tissue Work
      • 34.3.3 Bony Work
      • 34.3.4 Closure
    • 34.4 Limitations
    • 34.5 Complications and Avoidance
    • 34.6 Illustrative Cases
    • 34.7 Conclusions
    • References
  • 35 Retrosigmoid Approach
    • 35.1 Introduction
      • 35.1.1 Anatomical Background
      • 35.1.2 Indications
    • 35.2 Surgical Technique
      • 35.2.1 Patient Positioning
      • 35.2.2 Skin Incision and Soft Tissue Dissection
      • 35.2.3 Craniotomy
      • 35.2.4 Dural Opening and Intradural Steps
      • 35.2.5 Closure
      • 35.2.6 Complications
    • References
  • 36 Endoscopic Assisted Approach to the Cerebellopontine Angle
    • 36.1 History
    • 36.2 CPA Anatomy
    • 36.3 Advantages/Disadvantages
    • 36.4 Indications
    • 36.5 Vestibular Schwannoma
      • 36.5.1 Vestibular Schwannoma Endoscopic Assisted Approach Technique
    • 36.6 Trigeminal Schwannomas
      • 36.6.1 Trigeminal Schwannoma Endoscopic Assisted Approach Technique
    • 36.7 Epidermoid Tumors
    • 36.8 Meningiomas
    • 36.9 Other Tumors
    • References
  • 37 Infratemporal Fossa Approach to the Jugular Foramen
    • 37.1 Introduction
    • 37.2 Anatomy
    • 37.3 Technique and Tactics
      • 37.3.1 Positioning
      • 37.3.2 Incision and Superficial Dissection
      • 37.3.3 Muscle and Cervical Region Dissection
      • 37.3.4 Mastoidectomy and Craniotomy
      • 37.3.5 Tactics
    • 37.4 Closure
    • 37.5 Conclusion
    • References
  • 38 The Facial Reanimation: Multidisciplinary Approaches
    • 38.1 Introduction
    • 38.2 Different Facial Nerve Reconstruction Techniques
      • 38.2.1 Direct Neurorrhaphy
      • 38.2.2 Hypoglossal-Facial Nerve Neurorrhaphy
      • 38.2.3 Alternatives to Classic Hypoglossal-Facial Neurorrhaphy
      • 38.2.4 Masseteric-Facial Nerve Neurorrhaphy
      • 38.2.5 Accessory-Facial Nerve Neurorrhaphy
    • 38.3 Transfacial Anastomosis (Cross-Face Facial Nerve Anastomosis)
    • 38.4 Neuromuscular Transplant
    • 38.5 Conclusion
    • References
• Section VII Posterior and Lateral Approaches to the Craniocervical Junction
  • 39 Microsurgical Anatomy of the Foramen Magnum
    • 39.1 Brief Historical Review
    • 39.2 Introduction
    • 39.3 Surgical Anatomy of the FM Region
    • 39.4 Extradural Stage
      • 39.4.1 Nuchal Muscles and V3 Segment
    • 39.5 Anatomy of the VA
      • 39.5.1 Vertebral Venous Plexus
      • 39.5.2 Nuchal Lines Method
    • 39.6 Bone Structure and Articulations
      • 39.6.1 Occipital Bone
      • 39.6.2 Occipital Condyles
      • 39.6.3 Atlanto-occipital Joints
      • 39.6.4 Atlanto-axial Joints
    • 39.7 Dural Stage
      • 39.7.1 Dural Venous Sinuses
      • 39.7.2 Surgical Tips
    • 39.8 Intradural Stage
      • 39.8.1 Neural Elements
      • 39.8.2 Denticulate Ligament
      • 39.8.3 Cerebellum
      • 39.8.4 Nerves
      • 39.8.5 Vascular Elements
    • References
  • 40 Far-Lateral Approach and Its Variants
    • 40.1 Background
    • 40.2 Indications
    • 40.3 Surgical Technique
      • 40.3.1 Patient Positioning
      • 40.3.2 Skin Incision
      • 40.3.3 Intradural versus Extradural Approach
      • 40.3.4 Soft Tissue Dissection
      • 40.3.5 Bone Flap and Dura Opening
      • 40.3.6 Condyle Removal: The Transcondylar Approach
      • 40.3.7 Closure
    • 40.4 Complications and Avoidance
    • 40.5 Illustrative Cases
      • 40.5.1 Case 1
      • 40.5.2 Case 2
    • References
  • 41 Surgical Treatment for Atlantoaxial Instability
    • 41.1 Introduction
    • 41.2 Atlantoaxial Dislocation
    • 41.3 Basilar Invagination
    • 41.4 Chiari 1 Malformation and Syringomyelia
    • 41.5 Central or Axial Atlantoaxial Facetal Instability
    • 41.6 Investigations
    • 41.7 Surgery
      • 41.7.1 Operative Technique for Lateral Mass Plate (or Rod) and Screw (Monoaxial or Polyaxial) Fixation
    • 41.8 Complication Avoidance
    • 41.9 Craniovertebral Realignment for Group A Basilar Invagination: Role of Interarticular Cages
    • 41.10 Technique
    • 41.11 Atlantoaxial Fixation for Group B Basilar Invagination
    • References
  • 42 Endoscopic Approach to the Craniocervical Junction
    • 42.1 Introduction
    • 42.2 The Endoscopic Endonasal Approach
    • 42.3 Surgical Technique and Anatomic Landmarks
    • 42.4 The Endoscopic Transoral Approach
    • 42.5 The Endoscopic Transcervical Approach
    • 42.6 Surgical Technique
    • 42.7 Approach Selection
      • 42.7.1 Preoperative Imaging
    • 42.8 Patient Selection
    • 42.9 Limitations to the Endoscopic Approaches
    • 42.10 Conclusion
    • References
• Section VIII Approaches to the Posterior Incisural Space
  • 43 Anatomy of the Posterior Incisural Space: Microscopic Perspective
    • 43.1 Introduction
    • 43.2 Objective
    • 43.3 Microsurgical Anatomy
    • 43.4 Overview
      • 43.4.1 The Posterior Incisural Space
      • 43.4.2 The Inferior and Middle Surface of the Posterior Temporal Lobe and the Occipital Lobe
      • 43.4.3 The Tentorium
  • 44 Anatomy of the Posterior Incisural Space: Endoscopic Perspective
    • 44.1 Introduction
    • 44.2 History
    • 44.3 Anatomy
    • 44.4 Endoscopic-Assisted Microsurgery
    • 44.5 Conclusion
    • References
  • 45 The Occipito-polar Approach: Study of the Occipital lnterhemispheric Supratentorial Transtentorial Transfalcine Approach
    • 45.1 Introduction
    • 45.2 Patient Series, Anatomical Study, and Methods
      • 45.2.1 Anatomical Study and Patient Series
      • 45.2.2 Surgical Technique
    • 45.3 Illustrative Surgical Cases
      • 45.3.1 Case 1
      • 45.3.2 Case 2
    • 45.4 Evaluation of Surgical Outcomes of the Patients
    • 45.5 Results
      • 45.5.1 Anatomical Study of the Occipito-polar Approach
      • 45.5.2 Surgical Cases
    • 45.6 Discussion
    • 45.7 Conclusions
    • 45.8 Disclosures
    • References
  • 46 Supracerebellar Infratentorial Approach: Microsurgical Perspective
    • 46.1 Introduction
    • 46.2 Preoperative Evaluation
    • 46.3 Surgical Approach and Operative Techniques
    • 46.4 Median SCIT Approach
    • 46.5 Paramedian SCIT Approach
    • 46.6 Lateral and Extreme Lateral SCIT Approach
    • 46.7 Contralateral SCIT Approach
    • 46.8 Intraoperative Techniques
    • 46.9 Postoperative Management
    • References
  • 47 Supracerebellar Infratentorial Approach: Endoscopic Perspective
    • 47.1 Introduction
    • 47.2 Evolution of a Surgical Approach
      • 47.2.1 Supracerebellar Infratentorial Approach
    • 47.3 Optimization of Gravity Retraction: Sitting Position
    • 47.4 Use of the Endoscope in Neurosurgery
    • 47.5 Nuances of the Surgical Technique
    • 47.6 Sitting Position
    • 47.7 Off-Midline, Minimally Invasive Craniotomy
    • 47.8 Selection of Craniotomy Location
    • 47.9 Representative Cases
      • 47.9.1 Case 1
      • 47.9.2 Case 2
      • 47.9.3 Case 3
    • References
  • 48 Supracerebellar Transtentorial Approach
    • 48.1 Introduction
    • 48.2 Historical Landmarks
    • 48.3 Indications
    • 48.4 Preoperative Assessment
    • 48.5 Surgical Technique
      • 48.5.1 Anesthesia and Intraoperative Neurophysiological Monitoring
      • 48.5.2 Positioning
      • 48.5.3 Skin Incision and Muscle Management
      • 48.5.4 Craniotomy
      • 48.5.5 Dural Opening
      • 48.5.6 Microsurgical Dissection
      • 48.5.7 Tentorial Opening/Resection
      • 48.5.8 Microsurgical Anatomy
      • 48.5.9 Closure
    • 48.6 Conclusion
    • 48.7 Illustrative Cases
    • References
• Section IX Cerebrovascular Management for Skull Base Surgery
  • 49 STA-MCA Bypass
    • 49.1 Introduction
    • 49.2 Historical Landmarks
    • 49.3 Indications
    • 49.4 Surgery
      • 49.4.1 Preoperative Preparation
      • 49.4.2 Anaesthesia and Monitoring
      • 49.4.3 The Technique
      • 49.4.4 Closure
      • 49.4.5 Postoperative Care
      • 49.4.6 Follow-up
    • 49.5 Conclusion
    • References
  • 50 High-Flow Cervical Carotid Artery to Middle Cerebral Artery Bypass
    • 50.1 Introduction
    • 50.2 Indications and Preoperative Management
    • 50.3 Microsurgical Anatomy
    • 50.4 Interposition Graft
    • 50.5 Recipient Site
    • 50.6 Donor Site
    • 50.7 Technical Nuances
    • 50.8 Bypass Patency and Intraoperative Troubleshooting
    • 50.9 Conclusion
    • References
  • 51 Intracranial–Intracranial Bypass for Treatment of Complex Vascular Lesions and Tumors
    • 51.1 Introduction
    • 51.2 Intracranial-Intracranial (IC-IC) Bypass
      • 51.2.1 Single
      • 51.2.2 With Graft Interposition
      • 51.2.3 Combined
    • 51.3 Preoperative Assessment Study
    • 51.4 Surgical Procedure
    • 51.5 Discussion
    • 51.6 Conclusion
    • References
  • 52 Endoscopic Endonasal Approaches for the Treatment of Vascular Lesions
    • 52.1 Introduction
    • 52.2 Endoscopic Anatomy during Treatment of Vascular Lesions
      • 52.2.1 Vascular Anatomy
      • 52.2.2 Neural Anatomy
      • 52.2.3 Bony Anatomy
      • 52.2.4 Dural Anatomy
    • 52.3 Intraoperative Fluorescence and Imaging Tools in EEA for Vascular Lesions
      • 52.3.1 Endoscopic Indocyanine Green (endoICG)
      • 52.3.2 Sodium Fluorescein
      • 52.3.3 Intraoperative 3D Angiography (3D-DSA)
    • 52.4 Reconstructive Techniques in EEA
      • 52.4.1 Nasal Phase
      • 52.4.2 Sphenoidal Phase
      • 52.4.3 Sealing/Packing Phase
    • 52.5 Operative Nuances
    • 52.6 Aneurysms
      • 52.6.1 Anterior Circulation Aneurysms
      • 52.6.2 Posterior Circulation Aneurysms
    • 52.7 Complications
    • 52.8 Cavernous Malformations
      • 52.8.1 Technical Nuances
      • 52.8.2 Surgical Technique
      • 52.8.3 World Experience
    • 52.9 Vascular Tumors of the Skull Base
      • 52.9.1 Preoperative Evaluation
      • 52.9.2 Intraoperative Technical Nuances
    • 52.10 Conclusion
    • References
• Index
• Additional MedOne Access Information