Atlas of Surgical Approaches to Paranasal Sinuses and the Skull Base

311 Pages·2016·6.7 MB·English

by  Dan M. Fliss

Dan M. Fliss
Atlas of Ziv Gil
Surgical Approaches
to Paranasal Sinuses
and the Skull Base
123
Atlas of Surgical Approaches to Paranasal Sinuses
and the Skull Base

Dan M. Fliss (cid:129) Z iv Gil
Atlas of Surgical Approaches
to Paranasal Sinuses and
the Skull Base
Dan M. Fliss, MD Ziv Gil , MD, PhD
Department of Otolaryngology Head The Head and Neck Center
and Neck Surgery and Maxillofacial Surgery Department of Otolaryngology Head
The Interdisciplinary Center of Head and Neck Surgery
and Neck Surgical Oncology Rambam Healthcare Campus
Tel Aviv Sourasky Medical Center Haifa
Tel Aviv University Israel
Sackler Faculty of Medicine
Tel Aviv
Israel
ISBN 978-3-662-48630-6 ISBN 978-3-662-48632-0 (eBook)
DOI 10.1007/978-3-662-48632-0
Library of Congress Control Number: 2015960458
Springer Heidelberg New York Dordrecht London
© Springer Berlin Heidelberg 2016
T his work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is
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T he use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not
imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and
regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed
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express or implied, with respect to the material contained herein or for any errors or omissions that may have been
made.
Printed on acid-free paper
Springer-Verlag GmbH Berlin Heidelberg is part of Springer Science+Business Media (www.springer.com)
To my parents, Thea and Dr. Adolf Fliss, for their education, constant
support, and love.
To my wife, Maayana, for her love, patience, and encouragement.
To my beloved children, Neomi, Ehud, Ruth, and Yael, who continue to
provide perspective on what is truly important in life.
Dan M. Fliss
To my wife Abigail, for striding with me throughout my career and for the
creation of our garden.
Ziv Gil

Pref ace
T he skull base is one of the most complex anatomical regions in the human body. Being
located at the confl uence of the brain and upper aerodigestive tracts, it is also the origin of vari-
ous pathological processes of neoplastic, infectious, or congenital origin. In this setting, the
base of the skull was one of the last regions to be explored surgically. Throughout the twentieth
century, open skull base approaches were rapidly developed, but since they were associated
with considerable morbidity and had evident impact on function and cosmesis they created a
need for less aggressive techniques. In the past decade, the welcome infusion of new tools and
endoscopic technologies has enabled the skull base to become easier and safer to approach
surgically. The development of microvascular techniques and the maturation of endonasal sur-
gery contributed signifi cantly to the improvement of outcomes and quality of life of patients
with skull base neoplasms.
The twenty-fi rst century also brought the understanding that patients with skull base neo-
plasms should be managed in tertiary centers by a multidisciplinary team that involves sur-
geons, clinicians, and paramedical staff members from different fi elds of medicine. As surgeons
from diverse disciplines entered the fi eld of skull base surgery, there was a need for a compre-
hensive illustrated surgical atlas to serve as a reference tool for the management of these
patients.
This illustrated atlas is committed to a vision of interdisciplinary education in skull base
surgery. It provides a step-by-step description of the various surgical approaches to the skull
base. It is meant to be accessible to residents, fellows, and attendings in various disciplines,
including otolaryngology, head and neck surgery, neurosurgery, plastic and reconstructive sur-
gery, maxillofacial surgery, and oncology. Throughout, the emphasis is on the preoperative
workup, surgical technique, and postoperative follow-up. Each approach is explained in a
comprehensive manner and accompanied by intraoperative photographs.
In this atlas, we have introduced all the major approaches to the anterior, middle, and lateral
skull base, including open and minimally invasive approaches. The latest advancements in
endoscopic and transoral robotic surgery are also included. Case illustrations are presented and
discussed throughout this book. This atlas begins with three chapters on anatomical and
radiological reviews, followed by a chapter dedicated to operating room setup. Next, surgical
approaches are presented according to the anatomical region: the paranasal sinuses, anterior
skull base, lateral skull base, parapharyngeal space, and combined approaches. This book
concludes with two chapters dedicated to reconstructive skull base surgery and operative
complications. major classical and contemporary references are given at the end of each
chapter allowing guidance for those who are interested in further reading.
M any of our teachers and colleagues contributed to the development of ideas elaborated on
in these chapters. Lee Klein is highly thanked for his dedicated and thorough editorial
assistance. Above all, the gathering of this knowledge would not have been possible without
the support of our patients, which we were privileged to serve as their physician.
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About the Authors
Professor Dan M. Fliss M.D. is the Chairman of the Department of Otolaryngology Head and
Neck and Maxillofacial Surgery and the Interdisciplinary Center for Head and Neck Surgical
Oncology at Tel-Aviv Soursky Medical Center, affi liated to the Sackler Faculty of Medicine
Tel-Aviv University. He is also the Head of the Department of Otolaryngology Head and Neck
Surgery at the Sackler Faculty of Medicine, Tel-Aviv University, and on the Scientifi c Staff at
the Department of Otolaryngology Head and Neck Surgery, Mount Sinai Hospital, Toronto,
and the University of Toronto, Canada.
H e is currently the Scientifi c Secretary of the Asian Society of Head and Neck Oncology,
Councilor of the International Academy of Oral Oncology (IAOO), a member of the Executive
Committee of the International Federation of Head and Neck Oncology Societies (IFHNOS),
and an Honorary Member of many International Head and Neck Societies.
He is a frequent invited guest speaker at many international academic events among which
is the prestigious Eugene N. Myers International Lecture on Head and Neck Cancer.
Prof. Fliss serves on the editorial boards of T he Head and Neck Journal and is the editor of
the H ead and Neck Section of the Skull Base Journal, The Otolaryngology – Head and Neck
Surgery Journal, Oral Oncology, The J ournal of Operative Techniques in Otolaryngology
Head and Neck Surgery, the European Journal of Otolaryngology Head and Neck Surgery, and
others.
P rof. Fliss is the author of 300 articles and book chapters and the editor of three books on
Head and Neck and Skull Base Surgery: Atlas of Head and Neck Surgery (J.P. Medical),
Tumors of the Skull Base and Paranasal Sinuses (Springer), and P earls and Pitfalls in Head
and Neck Surgery (Karger).
Professor Ziv Gil, M.D., Ph.D., is a Barbara S. Goodman Endowed Investigator (ICRF) and the
Chairman of the Department of Otolaryngology Head and Neck Surgery, and the Head and
Neck Center at Rambam Healthcare Campus, Haifa, Israel. Professor Gil is the Director of the
Applied Cancer Research Laboratory at the Clinical Research Institute at Rambam and a
Senior Member of the Developmental Biology and Cancer Research Program, the Rappaport
Faculty of Medicine and Research, The Technion, Israel Institute of Technology. He is also a
study section member of the Israel Science Foundation, Israeli Cancer Research Association
and the Binational Israel-America Science foundation, and sits at the editorial boards of the
Head and Neck Journal , Otolaryngology – Head and Neck Surgery , Skull Base Journal ,
Operative Techniques in Otolaryngology and more. Dr. Gil is the author of over 160 manu-
scripts and book chapters in basic science research and medicine. His previous books include
Tumours of the Skull Base and Paranasal Sinuses (Springer) and Atlas of Head & Neck Surgery
(Jp Medical).
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