Microsurgical Anatomy Review of Bifrontal Limited Transbasal Approach – Quantitative and Anatomy Study

Ng, Ariel Francis; Quintero, Rubén Batista; Lahirish, Issa Ali Muftah; Holanda, Vanessa M.; Neto, Mateus Regin; Oliveira, Evandro de

doi:10.1016/j.wneu.2020.02.114

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…Once the dura is exposed, the superior sagittal sinus can be sec tioned in the anterior portion (Figure 2C,D). This extension allows more extradural expo sure of the anterior cranial base and opens to the nasal cavity [19].…”

Section: Bifrontal/transbasal Approachmentioning

confidence: 99%

Surgical Anatomy and Approaches of the Anterior Cranial Fossa from a Transcranial and Endonasal Perspective

Plou

Serioli

Leonel

et al. 2023

Cancers

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The technical development in skull base surgery, especially to the anterior cranial fossa, has allowed for improvement in the quality of life and the long-term prognosis of patients suffering from different types of tumors that can affect this anatomical area. Applying these advanced techniques requires a thorough understanding of the skull base anatomy and surrounding structures to perform surgery without potential intraoperative complications related to the pathology itself as well as potential complications related to the surgical approach that has been chosen to treat this pathology. The purpose of this paper is to offer a comprehensive review of the surgical anatomy of the anterior skull base and the technical nuances of the surgical approaches that are more frequently used in this region. Detailed knowledge of these aspects is essential both for the choice of the surgical approach and for its correct execution when an anterior cranial fossa lesion need to be resected.Abstract: The anterior cranial fossa (ACF) is a complex anatomical region that can be affected by a broad spectrum of pathology. For the surgical treatment of these lesions, many approaches have been described, each of them with different scope and potential surgical complications, often associated with significant morbidity. Traditionally, tumors involving the ACF have been operated by transcranial approaches; however, in the last two decades, endoscopic endonasal approaches (EEAs) have been gaining popularity. In this work, the authors review and describe the anatomical aspects of the ACF and the technical nuances of transcranial and endoscopic approaches for tumors located in this region. Four approaches were performed in embalmed cadaveric specimens and the key steps were documented. Four illustrative cases of ACF tumors were selected to demonstrate the clinical application of anatomical and technical knowledge, which are essential in the preoperative decision-making process.

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Section: Bifrontal/transbasal Approachmentioning

confidence: 99%

Surgical Anatomy and Approaches of the Anterior Cranial Fossa from a Transcranial and Endonasal Perspective

Plou

Serioli

Leonel

et al. 2023

Cancers

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“…The standard bifrontal, frontomedian, and anterior interhemispheric approaches are also anatomically well-studied classic neurosurgical approaches. 31 32 The areas of exposure on the anterior fossa and central skull base through these latter approaches are strongly limited compared with the pterional and supraorbital approaches. Especially the anterior interhemispheric approach causes significantly lower retraction of the olfactory bulbs compared with the lateral, medial, and median subfrontal routes.…”

Section: Discussionmentioning

confidence: 99%

“…A further factor could be our recent observation that during forced retraction of the frontal lobe the olfactory bulb may be significantly dislocated from the olfactory fossa but without consecutive transection of the fila olfactoria (Fig 4B). The standard bifrontal, frontomedian and anterior interhemispheric approaches are also anatomically well-studied classic neurosurgical approaches 33,34 . The area of exposures on the anterior fossa and central skull base through these latter approaches is strongly limited compared to the pterional and supraorbital approaches.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Anatomy and Microsurgical Relevance of the Outer Arachnoid Envelope around the Olfactory Bulb Based on Endoscopic Cadaveric Observations

Kurucz,

Ganslandt,

Buchfelder

et al. 2024

J Neurol Surg A Cent Eur Neurosurg

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Background: Surgical approaches to the anterior cranial fossa have great risk of damaging the olfactory tract and bulb. The goal of this study was to describe the outer arachnoid envelope around the olfactory bulb which plays significant role in the approach-related injury of the nerve. Material and Methods: A total of 20 fresh human cadaveric heads were examined as a following: 5 cadaveric heads were used to describe a gross overview of the topographic anatomy of the outer arachnoid cover of the olfactory bulb. In 15 cadaveric heads endoscopic surgical approaches were performed to examine the in situ undisrupted anatomy of the outer arachnoid around the olfactory bulb. Four cadaveric heads were used for lateral subfrontal approach, 5 heads for medial subfrontal, 3 heads for median subfrontal approach and 3 heads for anterior interhemispheric approach. Results: The outer arachnoid membrane of the frontal lobe attaches the olfactory bulb strongly to the above lying olfactory sulcus. Only the most rostral portion of the olfactory bulb became slightly detached from the frontal lobe. The outer arachnoid forms a decent protrusion around the tip of the olfactory bulbs. The fila olfactoria have their own outer arachnoid cover as a continuation of the same layer of the olfactory bulb. The effect of brain retraction and manipulation forces on the olfactory bulb and the role of the here located arachnoid membranes were visually analysed and described in detail through the performed four different neurosurgical approaches. Conclusion: The results of our observations provide important anatomical details for the preservation of smelling during neurosurgical procedures.

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“…Congenital malformations of the maxillofacial area rank third among other congenital anomalies. 70% of them are congenital nonunion of the upper lip and palate, and 30% -craniofacial dysostosis [15,18]. The most diverse are congenital malformations of the upper and lower jaws, which are expressed in deviations from the norm of their size, shape, position of the jaws and changes in syntopia (agnathia, micro-and macrognathia, prognathia, nonunion of the upper jaw and palate) [4,10,13,20].…”

Section: Introductionmentioning

confidence: 99%

Morphometric characteristics of skull and face parameters in fetuses and newborns

2021

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Modern science has a significant number of diagnostic methods: craniological, anatomical, ultrasound, radiological. The development of new research methods, such as ultrasound and X-ray methods (magnetic resonance imaging), forms the concept of ultrasound and X-ray norms at different stages of human development. Now it is important to study the anatomical variability of people, morphometric characteristics, relationships of organs, anatomical structures, their parts at all stages of human development. The purpose of the work is to establish normative morphometric parameters of the skull and face in fetuses and newborns, followed by construction of mathematical models. The study was performed on 57 preparations of human fetuses 4-10 months and 7 newborns using adequate anatomical methods: macropreparation, topographic anatomical sections, computed tomography, craniometry. The main parameters of the facial and cerebral skull were measured with the help of a centimeter tape, a thick, sliding compass and a caliper. Statistical analysis of the obtained data was performed using a licensed program RStudio. It is established that according to the graphs of the average values of the parameters of the skull and face, there are two periods of accelerated and two periods of slow development. For transverse skull length, face width and skull height, two periods of accelerated development from the 6th to the 8th month of fetal development and from the 9th month of fetal development to the neonatal period and two periods of delayed development from the 5th to the 6th months and from the 8th to the 9th month of fetal development were revealed. For the total height of the face – periods of accelerated development – from the 4th to the 6th month of fetal development and from the 7th to the 9th month of fetal development, periods of delayed development – from the 6th to the 7th month of fetal development and from the 9th month of fetal development to the neonatal period. On the basis of arithmetic mean data of transverse skull length, face width, skull height, total face height, models for predicting normative morphometric parameters in fetuses and newborns are constructed. The constructed models will serve as a norm for the subsequent determination of certain morphometric deviations to establish variants of the structure and malformations of the skull and face. Thus, our systematized data on the features of spatio-temporal transformations of morphometric parameters of transverse skull length, face width, skull height, total face height with subsequent construction of mathematical models will contribute to the individualization of the norm, improvement of early diagnosis methods and development of new methods for surgical correction of congenital defects of the skull and face.

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Microsurgical Anatomy Review of Bifrontal Limited Transbasal Approach – Quantitative and Anatomy Study

Cited by 4 publications

References 11 publications

Surgical Anatomy and Approaches of the Anterior Cranial Fossa from a Transcranial and Endonasal Perspective

Surgical Anatomy and Approaches of the Anterior Cranial Fossa from a Transcranial and Endonasal Perspective

Anatomy and Microsurgical Relevance of the Outer Arachnoid Envelope around the Olfactory Bulb Based on Endoscopic Cadaveric Observations

Morphometric characteristics of skull and face parameters in fetuses and newborns

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