METHOD FOR MICROSURGICAL ACCESS FROM LOW-TRAUMATIC MEDIUM SUBOCCYPITAL CRANIOTOMY TO NEGOLAMS OF THE POSTERIOR CRANIOUS FOSTURE Russian patent published in 2023 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to neurosurgery. A linear vertical incision of the skin and soft tissues of the cervical-occipital region is performed, 6 cm long. In this case, the incision begins 0.5 cm below the external occipital protrusion and continues down to the level of the spinous process of the second cervical vertebra. After preparation and retraction of soft tissues, an asymmetric osteoplastic trepanation is performed from one burr hole, installed along the midline 2.5 cm from the edge of the foramen magnum. The formed bone flap measuring 2.5 by 2 cm, including the posterior semicircle of the foramen magnum, is left on the intact posterior atlantooccipital membrane. The dura mater is dissected with an arcuate incision 1.5 cm long with its base facing the occipital sinus, which is not transected. One-sided preparation of the gap between the uvula of the worm and the tonsil of the cerebellum is carried out from top to bottom and medially to the level of the foramen of Mogendie, focusing on the inferior vein of the vermis, the posterior tonsil vein and the place of transition of the telelotonsillar segment of the posterior inferior cerebellar artery to its cortical segment.

EFFECT: method allows to improve the results of surgical treatment, reduce soft tissue injuries in the area of the craniovertebral junction, provide an adequate view of all parts of the IV ventricle and the rhomboid fossa, reduce the risk of postoperative liquorrhea due to hermetic suturing of the dura mater and preservation of the atlantooccipital joint, accelerate the activation of patients after surgery, reduce length of stay of patients in the hospital, reduce the cost of treatment.

1 cl, 7 dwg, 1 ex