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0 (hodnocen0 x )

EB

ONLINE

1st ed.

NEW YORK : Thieme Medical Publishers, Incorporated, 2021

1 online resource (244 pages)

ISBN 9781638536468 (electronic bk.)

ISBN 9781684200689

Print version: Gardner, Paul A. Vascular Challenges in Skull Base Surgery NEW YORK : Thieme Medical Publishers, Incorporated,c2021 ISBN 9781684200689

Vascular Challenges in Skull Base Surgery -- MedOne Access Information -- Title Page -- Copyright -- Dedication -- Contents -- Videos -- Preface -- Acknowledgment -- Contributors -- 1 Vascular Anatomy of the Head and Neck/Circle of Willis -- 1.1 Key Learning Points -- 1.2 Introduction -- 1.3 Anterior Circulation -- 1.3.1 Cervical Carotid Artery -- 1.3.2 Petrous and Lacerum Carotid Artery -- 1.3.3 Paraclival and Cavernous Carotid Artery -- 1.3.4 Supraclinoid Internal Carotid Artery -- 1.3.5 Anterior Cerebral Artery (A1 and A2 Segments) -- 1.3.6 Middle Cerebral Artery (M1 Segment) -- 1.4 Posterior Circulation -- 1.4.1 Vertebral and Basilar Arteries -- 1.4.2 Posterior Cerebral Artery (P1 and P2 Segments) -- 1.4.3 Extracranial-Intracranial Anastomoses -- 1.5 Conclusion -- 2 Evaluation of Tumor-Involved Vasculature (Including Balloon Test Occlusion) -- 2.1 Key Learning Points -- 2.2 Introduction -- 2.3 Arterial and Venous Anatomy -- 2.4 Imaging of Skull Base Vascular Tumors -- 2.4.1 Digital Subtraction Angiography (DSA) -- 2.5 Balloon Test Occlusion (BTO) -- 2.5.1 Balloon Test Occlusion Protocol -- 2.5.2 Alternative Common Adjuncts -- 2.6 Conclusion -- 3 Embolization of Skull Base Tumors -- 3.1 Key Learning Points -- 3.2 Introduction -- 3.3 Goal of Embolization and Injury Avoidance -- 3.4 Available Embolysates -- 3.5 Case Examples -- 3.6 Management Strategy -- 3.7 Potential Complications -- 3.8 Venous Anatomy -- 3.9 Conclusion -- 4 Vascular Supply of Local-Regional Flaps in Skull Base Surgery -- 4.1 Key Learning Points -- 4.2 Introduction -- 4.3 Extranasal Reconstructive Flaps -- 4.3.1 Anterior Pericranial Flap -- 4.3.2 Temporoparietal Fascial Flap -- 4.3.3 Temporalis Muscle Flap -- 4.3.4 Occipital Pericranial Flap -- 4.3.5 Facial Artery Musculomucosal (FAMM) Flap -- 4.4 Endonasal Reconstructive Flaps -- 4.4.1 Nasoseptal Flap.

10.3 Vascular Challenge -- 10.3.1 Anatomy of the Middle Fossa ICA -- 10.3.2 Endoscopic Aspects/Challenges -- 10.4 Injury Avoidance -- 10.4.1 Preoperative -- 10.4.2 Anatomical Risk -- 10.5 Impact of Pathologies -- 10.5.1 Operator/Intraoperative -- 10.6 Case Example -- 10.7 Management Strategy/Management Algorithm -- 10.7.1 The Surgeons -- 10.7.2 Cautery -- 10.7.3 Suture/Clip Repair/Ligation -- 10.7.4 Packing -- 10.7.5 Anesthesia Team -- 10.7.6 OR Staff (Technicians, Nurses, Neurophysiology, Blood Bank, and Additional Resources) -- 10.7.7 Neurointerventional/Endovascular Assessment and Treatment -- 10.8 Delayed Complications -- 10.8.1 Vasospasm -- 10.8.2 Pseudoaneurysm Formation/Carotid-Cavernous Fistula -- 10.9 Root Cause Analysis and Lessons Learned -- 10.9.1 Review of the Modern Literature (Search Strategy) -- 10.10 Conclusion -- 11 Dealing with Major Vascular Injuries During Endonasal Posterior Fossa Surgery -- 11.1 Key Learning Points -- 11.2 Introduction -- 11.3 Preoperative Considerations -- 11.4 Surgical Avoidance of Injury -- 11.5 Surgical Management -- 11.5.1 Bleeding Localization and Control -- 11.5.2 Extradural Bleeding -- 11.5.3 Intradural Bleeding -- 11.6 Closure and Reconstruction -- 11.7 Postoperative Management -- 11.8 Illustrative Case -- 11.8.1 Management Analysis and Root Cause Analysis of the Presented Case -- 11.9 Conclusion -- 12 Vascular Challenges in Anterior Skull Base Open Surgery -- 12.1 Key Learning Points -- 12.2 Introduction -- 12.3 Surgical Vascular Anatomy of Anterior Cranial Base -- 12.4 Pathologies Involving Anterior Cranial Base, Surgical Approaches, and Associated Vascular Challenges -- 12.5 Vascular Complications in Anterior Cranial Base Surgery -- 12.6 How to Avoid Arterial and Venous Complications? -- 12.7 Illustrative Case Example -- 12.7.1 Case History and Examination.

16.4.2 Technical Nuances.

7.7.1 High-Riding Distal Basilar Aneurysm (Basilar Tip and Basilar-Superior Cerebellar Artery [SCA] Aneurysm) -- 7.7.2 P2p or P2-P3 Junction Aneurysm -- 7.7.3 VA-PICA Aneurysm -- 7.7.4 VA-AICA Aneurysm (Midbasilar Aneurysm) -- 7.8 Injury Avoidance -- 7.8.1 Prevention of Frontalis Nerve and Temporomandibular Joint (TMJ) Injury -- 7.8.2 Preservation of Orbital Fascia -- 7.8.3 Avoiding Optic Nerve and Internal Carotid Artery (ICA) Injury -- 7.9 Related Pathologies -- 7.10 Case Examples -- 7.10.1 Case 1 -- 7.10.2 Case 2 -- 7.10.3 Case 3 -- 7.11 Management Strategy -- 7.11.1 Preoperative Management -- 7.12 Potential Complications -- 7.13 Conclusion -- 8 Endoscopic Endonasal Aneurysm Treatment -- 8.1 Key Learning Points -- 8.2 Introduction -- 8.3 Vascular Challenge -- 8.4 Injury Avoidance -- 8.4.1 Case Selection -- 8.4.2 Proximal and Distal Control -- 8.4.3 Contingency Planning -- 8.4.4 Reconstruction -- 8.5 Related Pathologies -- 8.6 Case Examples -- 8.6.1 Case 1 -- 8.6.2 Case 2 -- 8.7 Management Strategy and Potential Complications -- 8.7.1 Management of Intraoperative Rupture -- 8.7.2 ICA Sacrifice -- 8.7.3 Minimizing Postoperative Complications -- 8.8 Management Algorithm -- 8.9 Root Cause Analysis -- 8.10 Conclusion -- 9 Dealing with Major Intraoperative Vascular Injury During Endonasal Approaches to the Anterior Skull Base -- 9.1 Key Learning Points -- 9.2 Introduction -- 9.3 Relevant Anatomy -- 9.4 Vascular Challenges -- 9.5 Injury Avoidance -- 9.6 Related Pathologies -- 9.7 Case Example -- 9.8 Management Strategy -- 9.8.1 Initial Steps -- 9.8.2 ICA Injury -- 9.8.3 ACA Injury -- 9.9 Potential Complications -- 9.10 Management Algorithm -- 9.10.1 ICA -- 9.10.2 ACA -- 9.11 Root Cause Analysis (Post Hoc Analysis) -- 9.12 Conclusion -- 10 Dealing with Major Intraoperative Vascular Injury -- 10.1 Key Learning Points -- 10.2 Introduction.

12.7.2 Management Strategy and Complications -- 12.7.3 Other Options to Control Intraoperative Severe Bleeding in This Case -- 12.7.4 Root Cause Analysis of the Vascular Injury -- 12.8 Conclusion -- 13 Dealing with Vascular Injury During Middle Fossa Surgery -- 13.1 Key Learning Points -- 13.2 Introduction -- 13.3 Vascular Control and Injury Avoidance -- 13.4 Related Pathologies -- 13.5 Case Example -- 13.6 Management Strategy -- 13.7 Potential Complications -- 13.8 Management Algorithm -- 13.9 Root CauseAnalysis-Common Factors Leading to Carotid Artery Injury -- 13.10 Conclusion -- 14 Posterior Fossa During Open Skull Base Surgery -- 14.1 Key Learning Points -- 14.2 Introduction -- 14.3 Arterial Injury and Complications -- 14.3.1 Arterial Anatomy of the Posterior Fossa -- 14.3.2 Anatomical Variants -- 14.3.3 Management Strategies for Arterial Injury -- 14.4 Venous Injury and Complications -- 14.4.1 Venous Anatomy of the Posterior Fossa -- 14.4.2 Anatomical Variants -- 14.4.3 Management Strategies for Venous Injury -- 14.4.4 Dural Venous Sinus Thrombosis and Postoperative Management -- 14.5 Conclusion -- 15 Perforator Injury During Endoscopic Endonasal Skull Base Surgery -- 15.1 Key Learning Points -- 15.2 Introduction -- 15.3 Compartmentalization of Skull Base Perforators-Related Pathologies and Potential Complications -- 15.3.1 The Anterior Compartment -- 15.3.2 The Posterior Compartment -- 15.3.3 The Inferior Compartment -- 15.4 Injury Avoidance and Management Strategies -- 15.5 Case Example -- 15.5.1 Case Vignette -- 15.5.2 Discussion -- 15.5.3 Root Cause Analysis -- 15.6 Conclusion -- 16 Perforator Injury During Open Skull Base Surgery -- 16.1 Key Learning Points -- 16.2 Introduction -- 16.3 Vascular Challenges -- 16.4 Perforator Injury Avoidance -- 16.4.1 Fundamentals of Perforator Flow Monitoring and Injury Avoidance.

4.4.2 Lateral NasalWall Flap -- 4.4.3 Middle Turbinate Flap -- 4.5 Conclusion -- 5 Bypass in the Treatment of Skull Base Tumors -- 5.1 Key Learning Points -- 5.2 Introduction -- 5.3 Vascular Challenge -- 5.4 Injury Avoidance -- 5.5 Related Pathologies -- 5.6 Management Strategy -- 5.6.1 Internal Carotid Artery -- 5.6.2 Vertebral Artery (VA) -- 5.6.3 Basilar Artery -- 5.6.4 Middle Cerebral Artery -- 5.6.5 Anterior Cerebral Artery -- 5.6.6 Other Arteries -- 5.7 Technical Considerations -- 5.7.1 Technique of High-Flow Bypass -- 5.8 Outcomes and Complications -- 5.9 Case Examples -- 5.10 Alternative Strategies -- 5.11 Conclusion -- 6 Alternatives to Standard Bypass Techniques for Skull Base Tumors (Including Direct IMax Bypass) -- 6.1 Key Learning Points -- 6.2 Indications -- 6.3 Determination of Cerebrovascular Reserve -- 6.4 Traditional High-Flow Cerebral Revascularization Methodology and Limitations -- 6.5 Advantages of the Internal Maxillary (IMax) External Carotid-Internal Carotid (EC-IC) Bypass -- 6.6 IMax Artery-Importance of Preoperative Angiography -- 6.7 IMax Artery Anatomical Considerations -- 6.8 Autograft Selection for High-Flow Bypass -- 6.9 IMax Bypass Operative Technique -- 6.10 Illustrative Case 1 -- 6.11 Illustrative Case 2 -- 6.12 Limitations of the IMax Bypass -- 6.13 Advantages of IC-IC Bypass -- 6.14 Advantages of the "Bonnet" Bypass -- 6.15 Conclusion -- 7 Skull Base Approaches for Aneurysm -- 7.1 Key Learning Points -- 7.2 Introduction -- 7.3 Transzygomatic Approach -- 7.4 Transpetrosal Approach (Includes Posterior Petrosectomy and Anterior Petrosectomy) -- 7.4.1 Posterior Petrosectomy -- 7.4.2 Anterior Petrosectomy -- 7.5 Far Lateral Suboccipital Approach -- 7.5.1 Suboccipital Layer-by-Layer Muscular Dissection -- 7.6 Transcondylar (Fossa) Approach -- 7.7 Vascular Challenges.

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.

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(OCoLC)1295268719