A surgical approach to the upper vertebral artery between C1 and C2 is described. Following dissection of the posterior border of the sternocleidomastoid and the anterior border of the splenius capitis the two muscles are held apart and the levator scapulae is transected at its origin from C1. The cranial end of the vertebral artery can now be connected with the common carotid or external carotid arteries.
Objective: To describe the use of a novel electric vein stripper (EVS) for use in patients with varicosities of the greater saphenous vein and tributaries. Methods: In addition to standard procedures as performed in varicose veins of the lower limb, an EVS, powered by a standard high frequency electrocoagulation generator (HF), is introduced. The application of this new EVS makes it possible to avoid tearing of the structures of the subcutaneous tissue surrounding the greater saphenous vein, leaving the channel of the vein blood dry. Results: A preliminary study including two groups of patients - 20 in the Babcock group and 24 in the EVS group - resulted in significantly reduced pain and discomfort. An added benefit for the patients was the fact that postoperative compression bandages were not needed. Conclusions: Application of EVS can prevent bruising and haematomas in vein stripping can be avoided.
Starting from the carotid trigone, a surgical approach to the parapharyngeal part of the internal carotid artery is described. The retrostyloidal part of the lateropharyngeal space is opened up from laterocaudal after resecting the posterior belly of the digastric muscle and the styloidal muscles. Vulneration of the cranial nerves (VII, IX, X) has to be prevented.
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