Craniotomy, Frontotemporal, Opening and Closure
One of the most frequently used craniotomy sites over the fronto-temporal area is selected to show the operative steps. The head is shaved just prior to bringing the patient to the Anesthesia Induction Room. While under anesthesia the patient is positioned for surgery, in our case of a left frontotemporal craniotomy the head is turned as seen in Figs. 1 and 2. Care is taken that neck muscles are not taut to prevent any compression of the venous circulation. This is accomplished by keeping a firm pillow under one shoulder, depending on the way the head is turned (Fig. 1a and b). Another important rule in positioning the patient is to keep the head always above the level of the heart. It may be necessary or helpful to lower or turn the head during certain operative procedures. This possibility should be kept in mind ; however, even after repositioning the patient’s head should remain above the heart level (Fig. 2). The head may be placed on a doughnut-shaped headrest or a three-pronged head holder, either of which permits repositioning of the head during surgery. The eyes are now covered with a rubber sheet after inserting into the conjunctival sacs a mild aseptic ophthalmic ointment. The scalp is prepared with soap and water and an iodine-containing solution.
KeywordsIntracranial Aneurysm Burr Hole Bone Flap Stay Suture Periosteal Elevator
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