Suboccipital Craniectomy — Horseshoe Incision
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Except in infants, the sitting position is used most commonly in surgery of the posterior fossa. Certain precautions must be taken when using this position because of the danger of air embolism. The lower extremities must be wrapped with elastic bandages and elevated. An inflatable wrapping below the level of the diaphragm is an effective means of increasing the venous pressure thereby preventing air embolism. Bone wax must be used generously. Cut bone margins should be coated with wax even when not bleeding. Air emboli can be detected by an ultrasonic detector placed over the neck, blood gas analysis and/or by a stethoscope placed over the precordium. Treatment must be rapidly carried out. The patient’s head must be lowered, and the embolus aspirated via a catheter previously placed in the right atrium.
KeywordsPosterior Fossa Fourth Ventricle Cerebellar Hemisphere Marginal Sinus Posterior Fossa Surgery
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