Principles and Practice of Keyhole Brain Surgery by Teo Charles Sughrue Michael E

Author:Teo, Charles,Sughrue, Michael E.
Language: eng
Format: epub
Publisher: Thieme Medical Publishing Inc.
Published: 2015-04-08T04:00:00+00:00

8.13.5 Frontal Lobectomy: Opercular Sparing or Opercular Involving

Removing the frontal lobe (▶ Fig. 8.15 and ▶ Fig. 8.16) is easily accomplished through a small opening. The size of the opening is limited by cheating the bone flap and working underneath the bone edge to remove the medial and anterior frontal lobe regions. The craniotomy is centered over the “action zones,” which are the most posterior gyrus one plans to remove, and most lateral gyrus. These areas are where you need to focus your attention on what goes and what stays, and this is why you need to fully expose these parts. The frontal tip and medial brain are removed under the bone, and the anterior and medial extent of the bone flap are placed so that the reach under the bone edge is not so extreme that it makes these maneuvers unnecessarily challenging; however, it is completely unnecessary to remove bone anywhere near the superior sagittal sinus or onto the forehead.

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