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Surgical approach to the cerebellopontine angle and dissection of the temporal bone: a continuing medical education course at Hacettepe University

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Author(s): Surucu HS

Journal: Neuroanatomy
ISSN 1303-1783

Volume: 3;
Issue: 1;
Start page: 59;
Date: 2004;
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Keywords: anatomy | neuroanatomy | meeting | report | hacettepe

ABSTRACT
When two complex structures like cerebellum and pons build up anangle, the one formed is not simple like the ones formed by twointersecting lines in geometry, but one, difficult to understand even by thepeople who see and cut it every day. To get close to a tumor here, onewill have to cut the complex temporal bone but from which direction andhow? Answering to a question like this and many difficult others in oneday was the aim of this meeting. Diverging the attention to the surgicaltechniques and anatomy, rather than the indications of surgery made thisgoal accomplished successfully.There were 30 participants, of almost equal numbers of anatomists,otolaryngologists and neurosurgeons, by coincidence. Even this was givinga good clue about how the chosen field was in the center of clinical andbasic science cooperation. The plenary session started and chaired byRuhgun Basar. The first presentation by Nuran Yener was giving everydetail of clinical anatomy of the temporal bone. Following, Sarp Saracpresented mastoidectomy and facial nerve decompression techniques withbeautiful schematic slides and real operation movies. The movies werecleverly montaged focusing on the important moments and landmarks andcropping out the intervals in between. Otherwise the movies of these longoperations can be more difficult to watch than doing the operation.After a fifteen minute coffee break, the second session started with thebeautiful presentation of Levent Sennaroglu about labyrnthectomy andtranslabyrenthal approach to the cerebellopontine angle. He describedmedial, lateral and inferior approaches which are used for different purposes.The next presentation was about anatomy of the neurovascular structures ofthe cerebellopontine angle by Beliz Tascioglu. Her presentation was mostlyby real photographs and their explanory drawings at each slide. This typeof presentation supplied extreme good orientation to the surgeons besidesteaching the complex anatomy of the region.Ibrahim Ziyal presented the middle cranial and retrosigmoid approach ofthe neurosurgeons. He also demonstrated some operational movies andgave important clues to the surgeons. The discussion became interesting byparticipation of Dr Gokhan Akdemir and his experiences from his studieswith the famous surgeon Dr Mecit Sami.At the lunch everybody was fascinated with the presentations of the morningand waiting impatiently for the practical part which would be held in theanatomy dissection laboratory. The practicals were not less successful. Theanatomy laboratory has almost turned to an operation hall or even betterwith the dissection microscopes screed widely and clearly viewed fromall over the saloon and the voice of the operator amplified to be heard byeveryone. The equipment for the surgical demonstrations were excellent,most of them were just taken out from their boxes. Each approach to thecerebellopontine angle was demonstrated on the cadavers by experiencedsurgeons Sarp Sarac, Levent Sennaroglu and Ibrahim Ziyal. Afterwards,the participants were encouraged to practice all the approaches and theyhad the chance to ask the demonstrators to redemonstrate.The practicals were finalized with a closing sessionheld in the Anatomy laboratory, this time including theindications for various approaches to cerebellopontineangle. This session was moderated by Ibrahim Ziyal,there occurred a very useful discussion between OsmanE. Ozcan, Bulent Gursel and Levent Sennaroglu.A very beautiful dinner was waiting for the participantsas the final event of the day. It was held at the secondcampus of Hacettepe University (Beytepe campus), at a sightseeing restaurant-bar “Bright House”.This meeting concerning the surgical approach to thecerebellopontine angle and dissection of the temporalbone was accomplished with the contribution of authorsfrom both preclinical and clinical fields. The presentationswere of very high quality and the participants benefitedfrom every speech and discussion. The community planssimilar meetings for the next years.

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