Operative positions for the cranial base neurosurgical procedure: A study for complications and its avoidance

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Mohamed A Fahmy

University of Alexandria, Egypt

: J Spine Neurosurg

Abstract

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Aim: The study aims to determine the optimal surgical position for each surgical skull-based approach to minimize complications.

Method: Prospective study on a group of 30 patients with skull base lesions will experience careful extraction with patients in contrast careful positions as per proposed approach and assess the level of injuries openness and position identified with inconveniences revealed.

Result: Positions related complications are greatly decreased by adequate head position (extension, rotation in supine position, flexion in prone and lateral positions), strict head fixation using rigid fixator. Peripheral nerves injury can be minimized by adequate supination of forearm, shoulder abduction and avoidance of excessive shoulder bracing. An axillary roll should be placed under the upper chest in order to take pressure off the dependent shoulder in lateral position and so, decreasing the pressure on the axillary plexus.

Conclusion: The positions of the approaches to the skull base surgery demands meticulous head positioning (rotation, fixation, flexion and extension), four limbs adjustment and adequate care of cardiopulmonary state of the patient to gain best accessibility of the lesions with minimal complications to achieve the concept of (Retraction loss surgery) and/or (brain surgery without a spatula).

Biography

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Mohamed A Fahmy has completed his MB BCh in 1982 and then completed his Master of General Surgery. He has completed his Fellowship in the Department of Neurosurgery, received his Doctorate degree in Neurological Surgery. He was the House Officer in Ministry of Health Hospitals and Alexandria University Hospitals. He has worked as Physician in the Ministry of Health Hospitals from 1984 to 1987, as a Registrar of Neurosurgery in private hospital and worked as an Assistant Lecturer of Neurosurgical Department of Alexandria University Hospitals from 1988 to 1994. He was the Chief Consultant of Neurosurgery in Saqr Hospitals, UAE. He is currently working as a Professor of Neurosurgery Department at Alexandria University, Egypt.

E-mail: mohamedfahmy@hotmail.com