Parkinson surgery

Parkinson (1965) based on the microscopic anatomy of the cavernous sinus, first through the lower edge of the trochlear nerve on the outer wall of the cavernous sinus, the upper edge of the trigeminal nerve branch and the triangle between the saddle back and the slope line, the Parkinson triangle. Entering the cavernous sinus to treat a case of CCF, the effect is very satisfactory. However, due to the lack of effective intracavitary hemostasis, the operation was performed under deep hypothermia and extracorporeal circulation. Due to the high risk of surgery, coupled with the development of balloon catheter technology soon, few people have adopted it. He reported three times before and after, but he did not treat 4 cases. Treatment of diseases: cerebrovascular disease contraindications Due to the large invasion of Parkinson surgery, it is not suitable for elderly and frail patients with heart and kidney dysfunction. Preoperative preparation 1. Wash the head with soap and water 1 day before the operation, and shave the hair on the morning of the operation. You can also shave your head on the eve of surgery. 2. Fasting the morning of surgery. 3. Oral 0.1g can be given to phenobarbital before surgery to ensure a quiet rest. One hour before the operation, 0.1 g of phenobarbital, 0.4 mg of atropine or 0.3 mg of scopolamine were intramuscularly injected. 4. Preparation for extracorporeal circulation surgery. Surgical procedure 1. Craniotomy through the sinus approach, lifting the temporal lobe, and reaching the free edge of the cerebellum from the base of the cranial fossa. 2. Recognize the oculomotor nerve and the trochlear nerve into the cavernous sinus. In the Parkinson triangle, start at 4 mm below the entrance to the oculomotor nerve and make an incision about 2 cm in front of the oculomotor and trochlear nerves. 3. Use a small fixed retractor to retract the incision. Under normal circumstances, the two branches of the internal carotid artery in the cavernous sinus, namely the pituitary gland and the cavernous sinus artery, can be revealed. A large vein is seen around the internal carotid artery. 4. Anatomically thicken, varicose, and thickened the arterialized vein under the microscope. The pupil was found along the internal carotid artery, and the pupil was clipped with a silk thread or an arterial clip. The pupil could also be sutured with a 7-0 silk thread. 5. After the pupil is processed, the extracorporeal circulation is started to observe whether the arteriovenous fistula has been blocked. The sponge sinus incision was sutured with a 4-0 silk thread. Finally, the routine is closed. complication Due to the complicated method of anesthesia, there may be more complications and higher mortality after surgery. In recent years, since the application of effective hemostatic sponge in the surgery, for the open surgery of the cavernous sinus, anesthesia with cardiac arrest has not been required, and postoperative complications and mortality have been significantly reduced.