FRONTAL LOBECTOMY
Figure 3-3
Step 1. The patient’s head is held in a donut or fixed in a pinion, as illustrated here. The head should be slightly flexed and higher than the heart to promote venous drainage. To prevent partial kinking of the internal jugular veins, it is important not to overflex the head. The incision is a standard bicoronal incision. The medial edge of the bone nap should be along the superior sagittal sinus. This provides easier access to the interhemispheric fissure, with better visualization of the anterior cerebral artery and its branches. The posterior margin of the bone flap is at the coronal suture. The lateral margin extends from the junction of the coronal suture with the superior temporal line to the “keyhole.” Neurosurgery Books