By Dr. Paolo Cappabianca, Dr. Alessandra Alfieri, Prof. Dr. Enrico de Divitiis, Prof. Dr. Manfred Tschabitscher (auth.)
It is just lately that using the endoscope because the sole visualizing device has been brought in transsphenoidal pituitary surgical procedure with its favorable comparable implications and minimum operative trauma. in fact, microscopic and endoscopic anatomy are primarily an identical, however the optical distorsion of endoscopic pictures is kind of titanic in comparison to microscopic depictions. An endoscope lens produces pictures with maximal magnification at its middle and critical contraction at its outer edge. closer photographs are disproportionally enlarged and distant photos are falsely miniaturized. This optical phantasm may perhaps disorientate a physician who's no longer accustomed to this unusual on the cranium base. This atlas acts as a advisor in the course of the endoscopic anatomy and offers particular descriptions of the preoperative administration and the surgical procedures.
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Extra info for Atlas of Endoscopic Anatomy for Endonasal Intracranial Surgery
B. 1. 24 Right nostril, 0° endoscope. The middle nasal concha is the first landmark to be identified. By following its inferior margin the spheno-ethmoidal recess is reached. 25 Right nostril, 0° endoscope. The sphenoidal sinus ostium located at the upper part of the spheno-ethmoidal recess is the crucial point where the procedure starts. 29 I. B. 2. 26 Left nostril, 0° endoscope . The sphenoidal sinus ostium is broadened using KERRISON's rongeurs . 27 0° endoscope . Posterior wall of the sphenoidal sinus after removal of the septum of the sphenoidal sinus.
52 0° endoscope. Panoramic view of the sella turcica and parasellar region after bone removal. 43 I. B. 5. Parasellar region 5ph nOldal plan 55 rv Fig. 53 0° endoscope. Right side. Removal of the upper bony carotid protuberance with view of the right ophthalmic artery. 5P I'oda pi n ~-------i!. 54 0° endoscope. Left side. After the removal of the upper bony carotid protuberance the left intracavernous carotid artery has been displaced downward and medially, in order to expose the ophthalmic artery.
56 0° endoscope. Left side. Closer view of the cavernous sinus after medial displacement of the intracavernous carotid artery. The nerves converge towards the medial aspect of the superior orbital fissure. 45 I. B. 5. Parasellar region SS SU nor orb. 57 0° endoscope. Right side. The intracavernous carotid artery has been displaced medially, towards the sella turcica, to expose the intracavernous nerves. 58 30° endoscope turned to the right side. The intracavernous carotid artery has been displaced medially towards the sella turcica.
Atlas of Endoscopic Anatomy for Endonasal Intracranial Surgery by Dr. Paolo Cappabianca, Dr. Alessandra Alfieri, Prof. Dr. Enrico de Divitiis, Prof. Dr. Manfred Tschabitscher (auth.)