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Der postero-laterale Zugang zum foramen magnum (chirurgische Technik)

The postero-lateral approach to the foramen magnum

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Zusammenfassung

Prozesse, die im Foramen magnum ventral liegen, können durch 3 verschiedene zugangswege freigelegt werden: transoral, transzervikal oder dorsolateral. Der letztere bietet den besten Überblick über die Strukturen ventral von der Medulla oblongata. Durch den variablen, weitwinkeligen Einblick ist es möglich, die ventrale Region von C 1/2 bis zum Hypophysenstiel darzustellen (Abb. 4). Somit können die in Tabelle 1 angeführten Strukturen präpariert werden.

Das Wegfräsen des Tuberculum jugulare dürfte ein wesentlicher Schritt des dorsolateralen Zuganges sein, um den Einblick weit nach ventral zu ermöglichen. Durch diesen Zugang können sowohl ventrale intradurale Tumore als auch Aneurysmen des vertebro-basilären Abschnittes in der Region des Foramen magnum und der unteren Klivushälfte übersichtlich dargestellt werden.

Summary

Processes situated ventrally in the foramen magnum may be approached on three routes: the transoral, the transcervical and the dorso-lateral route. The latter offers the best view of the structures ventral to the brainstem. Due to caudal and rostral exposure the region is accessible from C 1 to the pituitary stalk. The removal of the jugular tubercle is of particular importance for exposing the structures in the ventral region of the foramen magnum, aside from the retromastoid craniotomy, which is performed far laterally. Through the approach ventral intradural tumors as well as vascular malformations of the vertebro-basilar junction may be exposed.

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Authors and Affiliations

  1. Neurochirurgische Klinik der Universität Wien, Währinger Gürtel 18-20, A-1090, Wien

    A. Perneczky

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  1. A. Perneczky
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Herrn Prof. Dr.H. Brenner zum 60. Geburtstag gewidmet.

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Perneczky, A. Der postero-laterale Zugang zum foramen magnum (chirurgische Technik). Acta Chir Austriaca 18, 426–430 (1986). https://doi.org/10.1007/BF02679859

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  • DOI: https://doi.org/10.1007/BF02679859

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