Avoiding Disaster at the Skull Base: Case Studies in 3D

Abstract

Program Description: Disaster awaits unprepared surgeons at the skull base. Multiple routine surgeries in otolaryngology are in close proximity to the skull base. Potential risks of endoscopic sinus surgery include cerebrospinal fluid leak, loss of olfaction, penetrating brain injury, visual loss, hemorrhage from the internal carotid artery, and loss of trigeminal sensory and motor function. Potential risks of temporal bone and lateral approaches include vascular injuries of the sigmoid sinus, jugular bulb, and internal carotid artery; injury to cranial nerves 7-12; cerebrospinal fluid leak, intra- and extradural hemorrhage; and brain trauma. A thorough understanding of skull base anatomy is essential for avoiding such complications during routine surgical procedures. In this miniseminar, case studies will be used to demonstrate potential risks of standard surgical procedures relative to the skull base. Important anatomical landmarks and relationships will be presented in 3D using cadaveric dissections and intraoperative photographs. Strategies to avoid skull base complications will be discussed with an emphasis on everyday surgical procedures.

Educational Objectives: 1) Understand key anatomical relationships at the skull base. 2) Relate skull base anatomy to anterior and lateral skull base approaches. 3) Apply anatomical knowledge to avoid surgical complications.