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Skull-base surgery: operative refinements.

Abstract
Advances in microsurgical techniques, with the use of the laser and the ultrasonic suction aspirator, have paved the way for even more aggressive surgical approaches to large skull-base lesions, such as glomus tumors, adenocarcinomas of the temporal bone, and cranial nerve neuromas. Postoperative morbidity of multiple cranial nerve dysfunction has been aggravated in the past by cerebrospinal fluid leakage and/or gastro-intestinal dysfunction. At the Otology Group, P.C., in the course of dealing with more than 86 skull-base tumors, we have developed a standardized, multispecialty approach to such extensive skull-base lesions, including tracheotomy, gastrostomy, "ventriculoatrial" shunt placement, and rotated temporalis muscle flap closure. This article presents cases that illustrate the evolution of the current, "standard skull-base" operative procedure and the rationale for incorporation of the shunt and the muscle flap closure as operative refinements. Their beneficial effects upon postoperative morbidity are detailed.
AuthorsA J Gulya, M E Glasscock 3rd, C G Jackson, M L Pensak, P F Harris, A Bond
JournalOtolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (Otolaryngol Head Neck Surg) Vol. 94 Issue 3 Pg. 315-21 (Mar 1986) ISSN: 0194-5998 [Print] England
PMID3008061 (Publication Type: Case Reports, Journal Article)
Topics
  • Adolescent
  • Adult
  • Cerebrospinal Fluid Shunts
  • Female
  • Glomus Jugulare Tumor (surgery)
  • Humans
  • Jugular Veins
  • Male
  • Mastoid (surgery)
  • Microsurgery (methods)
  • Middle Aged
  • Paraganglioma, Extra-Adrenal (surgery)
  • Skull (surgery)
  • Surgical Flaps
  • Temporal Muscle (surgery)
  • Tracheotomy

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