Transcrusal approach to the retrochiasmatic region with special reference to temporal lobe retraction: an anatomical study
スポンサーリンク
概要
- 論文の詳細を見る
Background: The retrochiasmatic region is one of the most challenging areas to surgically expose. The authors evaluated the transcrusal approach, which involves removal of the superior and posterior semicircular canal from the ampulla to the common crus, to expose the retrochiasmatic region and compared it with the retrolabyrinthine approach, both of which are a variation of the posterior petrosal approach with hearing preservation, with a special emphasis on the influence of temporal lobe retraction. Methods: Six sides of silicone-injected cadaveric heads were dissected using two approaches: the transcrusal approach and the retrolabyrinthine approach. For each craniotomy, 3 exposure parameters in the retrochiasmatic region were measured: (1) horizontal distance, (2) vertical distance, and (3) triangular area of exposure, at three different levels of temporal lobe retractions: 0, 5, and 10 mm of retraction from the level of the tentorial incisura. Results: Without temporal lobe retraction, only the transcrusal and not the retrolabyrinthine approach provided a direct exposure of the retrochiasmatic region, especially in the horizontal distance (p < 0.001). At all levels of temporal lobe retraction, the transcrusal approach provided greater exposure in the horizontal and vertical distances and in the area of exposure. Nonetheless, in the horizontal distance, the difference between the transcrusal and retrolabyrinthine approaches decreased along with increased temporal lobe retraction, and almost no difference was obtained at 10 mm of retraction. Conclusions: Posterior petrosal approaches can provide an excellent exposure of the retrochiasmatic region. Of these two approaches, namely, transcrusal and retrolabyrinthine with hearing preservation, the transcrusal approach offers greater exposure than the retrolabyrinthine approach. The beneficial effect of partial labyrinthectomy of the transcrusal approach to the retrochiasmatic region is accentuated in the exposure of the horizontal distance with less temporal lobe retraction. © 2010 Springer-Verlag.
論文 | ランダム
- 看護診断と記録--看護成果(看護アウトカム)と看護介入をふまえて (連続特集1 看護記録--情報の共有をめざした看護記録の検討)
- 看護記録がめざすもの--個別の療養生活の再現と実践の言語化 (連続特集1 看護記録--情報の共有をめざした看護記録の検討)
- 連続特集1 看護記録--情報の共有をめざした看護記録の検討
- 海外最新レポート アメリカにおける電子カルテ・看護記録システム--アボット・ノースウェスターン病院の一例から (特集 手術を受けるがん患者の看護--根拠に基づく知識と最新のトピックス)
- 看護記録に関するアンケート調査の報告