"If you don't do a second CT, would it be useful to start the navigation?" Huang Zhilei had to say that her idea was a bit strange, and directly suggested to her, "You don't have to use the navigation at all. You can think of it yourself. You should be able to figure it out in your head."
Xie Wanying: ...Senior Brother Huang, what do you think I am?
Junior sister's brain is a super three-dimensional computer.
"I want to use the navigation." Xie Wanying requested her senior brother. She didn't want to appear to be a particularly weird person. Besides, there are advanced medical technologies and everything can be put to good use, so why not use it to assist herself.
Senior Brother Huang was as happy as Senior Brother Cao: "I'll turn it on for you."
In fact, the three-dimensional navigation positioning markers mentioned earlier use the point registration method. Sometimes the positioning markers are afraid of being displaced, so the patient's face is directly scanned with a laser scanner in the operating room to obtain facial matching.
It's called the face-to-face matching method. However, this method has limitations and is not very accurate for matching the back of the head.
Based on the above principle, without using positioning markers or scanners, Xie Wanying uses her own eyes to scan and position the patient's head, and then benchmarks it to the navigation software.
The biggest advantage of the navigation software for her is that the three-dimensional images can be displayed on the screen more intuitively, making it easier for her to discuss with other doctors. After all, it would be too time-consuming and laborious for her to describe the images in her mind and draw them.
"Here, here." Xie Wanying took a cotton swab and showed her senior brother the location of the opening that could be made on the patient's head.
The anesthetists put their heads together and watched the strangeness.
Lu Yanhan, who had never seen a neurosurgery before, asked in surprise: "Is this going to be an operation on the eyebrow?"
Eyebrow piercing, which at first sounds like eyebrow surgery, is actually a very typical surgical approach in neurosurgery called the transbrow keyhole approach. A small incision is made on the eyebrow, as Xie said,
A small bone window as big as a dollar coin is opened, and the doctor can access the anterior cranial fossa and suprasellar region of the brain through this position, and perform surgery on these diseased areas.
There are many surgical approaches in neurosurgery. For example, in the previous drilling and drainage surgery for hydrocephalus cases, there were only three conventional approaches and countless other unconventional approaches. Therefore, navigation is required to choose the best approach.
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Xie now proposes two surgical approaches to choose from, one is from the eyebrow opening, and the other is from the hairline point. The surgical approach from the hairline point is the pterional approach.
The pterion is also the apex of the sphenoid, located in the front of the temporal fossa of the skull, where the frontal bone, parietal bone, temporal bone, and greater wing of the sphenoid bone meet.
The intersection of bones means that there is a bone suture here, which means that the bone here is relatively thin and easy to drill holes. It is also one of the classic approaches for neurosurgery, targeting the sellar area, anterior cranial fossa, and middle skull.
Surgery is performed on diseased areas such as the fossa and upper slope.
From the perspective of a person's head, the opening positions of these two entrances are not too far apart, and the targeted areas partially overlap.
For doctors, what are the factors that determine the final choice?
It must be said that the principle of surgical approach selection in neurosurgery is to avoid excessive stretching of the brain tissue, reduce damage to the brain tissue, and at the same time, expose the lesion to the greatest extent possible.
For the current case, whichever path is easiest to find the parasite and causes the least damage to brain tissue is the best.