The past and the present of cranial base surgery
Sameš M.1,2, Vachata P.1,2,3
1Neurochirurgické oddělení, MN, Ústí nad Labem 2Anatomická laboratoř báze lební, MN, Ústí nad Labem 3Anatomický ústav, 1. LF UK, Praha |
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Summary:
The authors provide a review, previously unpublished in our country, of the development of cranial
base surgery.This deals with the surgical solution of developmental,traumatic, vascular and tumourous
pathology in the anatomically most complicated regions of the human body. Explosive development of
this surgery occurred in the last twenty years. The development of cranial base surgery relied on
improvement in microsurgical techniques and knowledge of microanatomy in this region (detailed
topographical relationships of the CNS and cranial nerves, vessels, intraosseous organs of the temporal
bone and other anatomical structures of the skull base).The development also paralleled that of imaging
radiological techniques CT,MRI, DSA, of intervention radiology and, of course, of anaesthesia. A necessary
requirement was the interdisciplinary collaboration of neurosurgery, otology and maxillofacial
surgery, where each discipline had to overstep its boundaries. An extensive region of skull base is
anatomically divided into 1. anterior fossa and hypophysal region, 2. posterior fossa, pontocerebellar
angle and temporal bone, 3. middle fossa and 4. the central region of skull base. Given chapters present
an overview of the development of individual surgical approaches and the detailed references are at
the same time the basis for study and theoretical mastering of modern surgical technologies. In this
way, these surgeries stopped being the exclusive domain of 3-4 most advanced surgeons in the world
and these pathologies could be systematically and successfully solved in individual countries. Concentration
in specialized centres was necessary. The discussion also gives an overview of the development
of the world and European specialized society, including the history of the top world and European
conferences. A special attention is paid to the development of cranial base surgery in our countries.
Key words:
surgery, skull base, history, surgical approaches
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