4.4 Article

Basal Cisternostomy for Severe TBI: Surgical Technique and Cadaveric Dissection

Journal

FRONTIERS IN SURGERY
Volume 9, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fsurg.2022.915818

Keywords

severe brain trauma; decompressive craniectomy (DC); skull base; cisternostomy; cadaveric dissection

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This article presents the surgical technique of basal cisternostomy, including procedures such as craniotomy and sphenoidal drilling. This promising technique does not require complex maneuvers and can be safely implemented by trained neurosurgeons.
Introduction: Cisternostomy is emerging as a novel surgical technique in the setting of severe brain trauma. Different surgical techniques have been proposed with a variable degree of epidural bone work. We present here the surgical technique as it is currently performed in our Institution. Methods: Anatomical dissection of one adult cadaveric head, injected and non-formalin fixed was perfomed. A large right fronto-temporo-parietal craniotomy was accomplished. Extradural sphenoidal drilling till opening of the superior orbital fissure was performed. The microsurgical anatomy of basal cisternostomy was then explored. Results: A step by step description of the surgical technique, enriched with cadaveric and intraoperative images, was made. Conclusion: Basal cisternostomy is a promising surgical technique that does not necessarily include complex surgical maneuvers. Trained neurosurgeon can safely implement it in their clinical practice.

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