"If you don't do a second CT scan, will it be useful to start navigation?" Huang Zhilei had to admit that her idea was a bit strange, and he directly suggested to her, "You don't need navigation at all, think about it yourself, you should be able to figure it out."
Xie Wanying: ...Senior Brother Huang, what do you think of me?
Junior sister’s brain is a super three-dimensional computer.
"I want to use navigation." Xie Wanying asked her senior brother, not wanting to appear to be a weirdo. Besides, there was advanced medical technology, so why not use it to assist herself?
Senior Brother Huang was just 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, if the positioning marker is not moved, the patient's face will be scanned directly with a laser scanner in the operating room to obtain a facial match, which is called the 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 the need for positioning markers or scanners, Xie Wanying uses her own eyes to scan and locate the patient's head, and then aligns it with the navigation software.
The biggest benefit 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 is too time-consuming and laborious for her to speak out and draw the images in her mind.
"Here, here." Xie Wanying took a cotton swab and asked her senior brother to draw the location where the opening could be made on the patient's head.
...
...
The anesthesiologists leaned forward to watch the curious scene.
Lu Yanhan, who had never seen a neurosurgery operation, asked in surprise: "Are they going to operate on my eyebrows?"
Eyebrow piercing may sound like eyebrow surgery at first, but it is actually a very typical surgical approach in neurosurgery called the trans-superciliary keyhole approach. A small incision is made on the eyebrow, as Xie said, to create a small bone window the size of a one-yuan coin. After entering from this position, the doctor can access the anterior cranial fossa and the sellar region and suprasellar region of the brain, and perform surgery on these lesion areas.
There are many surgical approaches in neurosurgery. For example, in the previous burr hole drainage surgery for hydrocephalus, there are only three conventional approaches and countless other unconventional approaches, so navigation is required to select the best approach map.
Xie now proposed two surgical approaches, one from the eyebrow opening and the other from the hairline. The surgical approach from the hairline is the pterional approach.
The pterion is also the apex of the sphenoid bone, located in the anterior part of the temporal fossa of the skull, where the frontal bone, parietal bone, temporal bone, and greater wing of the sphenoid bone meet.
The meeting point of bones means that there is a suture, which means that the bone here is relatively thin and easy to drill a hole. It is also one of the classic approaches for neurosurgery, and is used to perform surgery on lesions in the sella turcica, anterior cranial fossa, middle cranial fossa, and upper slope.
From the perspective of the human head, the openings of these two approaches are not too far apart, and the targeted areas partially overlap.
What are the factors that determine the final choice for doctors?
It is important to mention that the principle of surgical approach selection in neurosurgery is to avoid excessive traction on brain tissue and reduce damage to brain tissue, while at the same time exposing the lesion as much as possible.
For the current case, the best path is the one that is easiest to find the worm and causes the least damage to brain tissue.
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