The Modular Concept in the Lateral and Posterior Skull Base Approaches: Anatomico-clinical Study.

Cho, Joo Yeon; Kim, Han Kyu; Lee, Hwa Dong

Original Article

Journal of Korean Neurosurgical Society 1999;28(7): 903-914.

Department of Neurosurgery, College of Medicine, Kosin University, Pusan, Korea.

ABSTRACT

OBJECTIVE
Despite advance in the surgical treatment of the skull base lesions, reaching the ventral brain stem is not familiar to us yet. No traditional complex skull base approaches have a value not only in treating complex and unusual skull base pathology but also in providing a better and safer exposure to traditional pathology. However, a more widespread use of these complex skull base approaches is predicated on a clear understanding of the topographical areas of the skull base exposed and on how these complex approaches can improve the exposure afforded by more conventional surgical routes. PATIENTS AND METHODS: The study was performed on 43 surgical dissection with 20 embalmed cadevaric heads in which the cephalic vascular system had been injected with colored silicone material.
RESULTS
AND CONCLUSIONS: This paper provides an visual anatomical understanding of the areas of the skull base exposed by the approaches examined using the same cues(CT and MRI) that the surgeons use in selecting an approach when confronted with a real lesion and makes them to apply to the clinical situations properly and intimately for the optimal treatment. In addition, with the modular concept, the neurosurgeon may better understand how complex skull base approaches are derived and modified from, and improve the exposure of basic, well known conventional neurosurgical approaches as building block.

Key Words: Skull base approach; Ventral brain stem; Modular concept