| 摘要 |
FIELD: medicine.SUBSTANCE: there is performed a pole-formed skin incision in a cervico-occipital region from a posterior nuchal line to a spinous process of C7 vertebra with a section line extending at 3-5 mm from a mastoid notch to the medial direction. An occipital bone, a posterior half-arch of C1 vertebra, half-arches and spinous processes of C2-C4 vertebras are skeletonised. That is followed by a medial transposition of a vertebral artery ensured by a foraminotomy of C2-C4 vertebras and a mobilisation of V2-segment of the vertebral artery from openings of the transverse processes of C2-C4 vertebras. A lateral suboccipital craniectomy involves a resection of a rim of the greater foramen up to a periphery of a sigmoid sinus. There are performed a hemilaminectomy of C1-C2 vertebras and a partial hemilaminectomy of C3 vertebra. An extradural dissection is followed by mobilising an occipital process from a posterior cranial fossa. The medial occipital process is resected to form an inside cavity. A dura mater is exposed at 3-7 mm from an edge of the atlantooccipital joint to the body mid-line towards the posterior cranial fossa, up to cerebral hemispheres, and to a vertebral canal, to the level of C3 vertebra. A superolateral tumour is visualised bringing the dura mater inwards the newly formed cavity in the occipital process.EFFECT: method enables increasing a surgical angle when mobilising the superolateral tumour that provides maintaining the atlantooccipital stability.1 ex |
