Fig. 4
From: The middle fossa approach with self-drilling screws: a novel technique for BONEBRIDGE implantation
Intraoperative pictures of middle fossa approach to BONEBRIDGE implantation with self-drilling screws. a Outline receiver well for implant using a standard otologic drill. b A smaller otologic drill is used to remove bone down to the dura to facilitate a vertical wall for the cylindrical craniotomy. c Small dural vessels are addressed with bipolar electrocautery. d Surgicel is used for hemostasis and slight tenting of dura away from the craniotomy. e Implant secured using self-tapping screws and BONEBRIDGE lifts. f Intraoperative picture from a patient before the availability of dedicated lifts. Rings cut from Synthes MatrixMIDFACE plates were purposed as custom lifts