Basal Cisternostomy for Severe TBI: Surgical Technique and Cadaveric Dissection

Front Surg. 2022 May 6:9:915818. doi: 10.3389/fsurg.2022.915818. eCollection 2022.

Abstract

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.

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

Grants and funding

Open access funding provided by University of Lausanne.