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《Chinese Journal of Neurosurgery》 2005-06
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An exploration to the practicality of nine approaches of minicraniotomy

WANG Xiang-yu, KE Yi-quang, WANG Qing-hua, et al. Department of Neurosurgery, Pearl River Hospital, Southern Medical University, Guangzhou 510282, China  
Objective To decrease the injury to the patients during craniotomy while insuring to obtain the adequate management for their intracranial lesions. Methods We designed the operation personally for every patient based on the routing operative approaches with our improvement, or redesign and blazing the trails in order to decrease the skin incision and bone flap (minicraniotomy). Results We operated successfully 127 cases of intracanial lesions with minicraniotomy, including brain tumors, intraparenchymatous and intraventricular hematomas, infectious diseases and vessel compression diseases.9 kinds of minicraniotomy have been relative matured by reference, exploration and improvement. The decision for minicraniotomy and appreciate approach were based on the lesion's location, classification, size, depth from brain surface, surrounding structures and available natural pathways. The minicraniotomies (bone flap Φ2.5~3.0 cm) were designed on lateral supraorbit, middle and posterior temporal area, torcular herophili region, posterior region of sigmoid sinus, occipital squama, sagittal midline area and cerebral convexity. The CSF extra-drainages by lumbar puncture were performed for increasing exposure by brain collapse. To locate the lesions were made by imaging materials, anatomical markers, stereotaxic frame, neuronavigation and intraoperation ultrasonic techniques. The microneurosugical techniques were used for eliminating lesions safely, effectively and little traumatically. But some kinds of lesions were not generally suitable to operated by minicraniotomy, such as large lesions, or lesions with serious brain edema, or lesions invading surface or skull base broadly, and intractable vessel diseases. Conclusions Minicraniotomy has its own practicalities, and also has its own limitations. The choice and success of this operation depend on the lesion's features, personal designing for operation, the surgeon's technologies of microsurgery and some available supplementary.
【CateGory Index】: R651
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