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35e! ===========================---------------~ FIG . 17 H 10m m \ speculum © asp _ -. n~ t~ level '\ ot op. approach I FIG. ,- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - " 36 Fig. 18. Special anatomical features and special techniques of hypophysis operations Principles of operation with narrow Apertura piriformis A Apertura piriformis too narrow for insertion of speculum B Alternative procedure 1: resection of bony wall of Apertura piriformis. Disadvantage: Sinus maxillaris and teeth are adjoining (see Fig.

30. Positioning of patient Position of patient on operating table and X-ray position B Anatomical sketch from A. The neurosurgeon does not sit, as is customary, at the side of the patient, but above patient's head as for trepanations.

27 .... 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _---'154 Fig. 27. Instruments for oronasal hypophysis operation (HARDY) A Retractor for holding back the upper lip B - D Instruments for gingiva incision E + F Dissector for detachment of mucosa from Septum nasi and floor of Meatus nasalis info G Spatula for holding back mucosa from Septum nasi I + H Shapeable spatulas for holding back torn mucosa s. Fig. 20 J Hardy speculum 10 mm FIG. 1_ _ _ _- - . J1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 56 Fig.

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CAS-CERN Accelerator School - 3rd General Accelerator Physics Course


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