Chapters authored
Surgical Anatomy of the Tonsils
The tonsils represent a circular band of mucosa associated with lymphoid tissues, Waldeyer’s ring, which is located at the entrance of the upper aerodigestive tract, with a significant role in the immune defense system. Waldeyer’s ring is composed of the pharyngeal, tubal, palatine, and lingual tonsils acting as secondary lymphoid tissues. Particularly, the palatine tonsils are the largest of the tonsils with deep branching crypts and contain B and T lymphocytes and M cell which plays a role in the uptake and transport of antigens. Because of the tonsil enlargement during childhood, upper airway obstruction and obstructive sleep apnea syndrome are mostly seen. Knowledge of the surgical anatomy of the tonsils and variations of the neurovascular and muscular structures around it allows optimal choice of surgical technique to avoid iatrogenic complications during tonsillectomy. Recent medical studies reported that a detailed understanding of the anatomic risk factors in upper airway obstruction allows to predict treatment response to surgical intervention. Due to the penetration of benign or malign lesions of the tonsil into the lateral wall of the pharynx, transoral robotic approach to this region is necessary to identify the surgical anatomic landmarks which are required to perform safe and effective surgical intervention.
Part of the book: Oral and Maxillofacial Surgery
Surgical Anatomy of the Temporal Bone
Numerous neurological lesions and tumors of the paranasal sinuses and oral cavity may spread into the middle and posterior cranial fossae through the anatomical apertures. For the appropriate management of these pathologies, many extensive surgical approaches with a comprehensive overview of the anatomical landmarks are required from the maxillofacial surgery’s point of view. The surgical significance lies in the fact that iatrogenic injury to the petrous segment of the temporal bone including the carotid artery, sigmoid sinus, and internal jugular vein, can lead to surgical morbidity and postoperative pseudoaneurysm, vasospasm, or carotid-cavernous fistula. To simplify understanding complex anatomy of the temporal bone, we aimed to review the surgical anatomy of the temporal bone focusing on the associations between the surface landmarks and inner structures. Also, breaking down an intricate bony structure into smaller parts by compartmental approach could ease a deep concentration and navigation. To identify the anatomic architecture of the temporal bone by using reference points, lines and compartments can be used to supplement anatomy knowledge of maxillofacial surgeons and may improve confidence by surgical trainees. Especially, this systematic method may provide an easier way to teach and learn surgical spatial structure of the petrous pyramid in clinical applications.
Part of the book: Oral and Maxillofacial Surgery