The Cranial Nerves Anatomy · Pathology · Pathophysiology · Diagnosis · Treatment

No special field of surgery dealing with the cranial nerves exists today. This is not surprising in view of the characteristics of this group of morphologically and topo­ graphically heterogenous nerves. Morphologically we must differentiate between central nerves (I, II and VIII) and the so-called peripheral nerves (nn. III to VII and IX to XII), in which post-lesion rgeneration is quite different. Anatomo-topographi­ cally we must consider an intracranial and an extracranial part of each cranial nerve. For practical reasons at operation, further subdivisions of the intracranial course of cranial nerves are to be distinguished in the anterior, middle and posterior cranial fossae as well as within the petrous bone. This underscores the extensive tasks awaiting surgeons operating in the ventral part of the brain and facial skull as well as in the more dorsal part of the skull and neck. This very wide field cannot be covered by a single surgical discipline alone. In our opinion, considerable progress has been made in surgery of the cranial nerves only in recent years. This may be explained by the increased mastery of microsurgical techniques by all surgeons in­ terested in the surgery of the base of the skull as well as with the initiation of more interdisciplinary consultation and jointly performed operations. Possibilities of fu­ ture development can be discerned in the text. The base of the skull separating the extra-and intracranial part of cranial nerves should not be a barrier but a connect­ ing link.

History of Cranial Nerves Surgery. Introductory Lecture.- Topographical Anatomy of the Cranial Nerves.- Cranial Nerve Injury. Structural and Pathophysiological Considerations and a Classification of Nerve Injury.- Experimental Studies on Neural Regeneration.- Olfactory Nerve (First Cranial Nerve).- Functional Testing and Disturbances of Olfactory Sense.- Clinical Aspects of Gustatory Sense.- Some Remarks About the Olfactory Nerve from the Surgical Point of View.- Preservation of the Olfactory Tract Following Operation on Anterior Communicating Artery Aneurysm Using Bifrontal Craniotomy, and Its Functional Prognosis.- The Nervus terminalis.- Olfactory Nerve.- Optic Nerve (Second Cranial Nerve).- Optic Nerve, Topographic Anatomy.- Optic Nerve. Clinical Examinations and Findings.- Diagnosis of Optic Nerve Lesions with Newer Technique of Computerized Tomography.- Misinterpretation of Progressive Visual Disturbances.- Transcranial Decompression of Optic Nerve After Trauma.- Microsurgical Transethmoidal Optic Nerve Decompression: Experience in 700 Cases.- Childhood Optic Gliomas. Microsurgical Treatment.- Optic Nerve Glioma: General Considerations and a Case Report.- Optic Nerve Compression by Pituitary Adenomas.- Optic Nerve Compression by Meningiomas.- Compression of the Optic Nerve by Cerebral Aneurysm — Based Upon the Experience in 1000 Operative Cases.- Optic Nerve Compression by Other Intracranial Etiology.- On the Pathogenesis and Prognosis of Lesions of the Optic Nerve in Hydrocephalic Patients.- Optic Nerve Compression by Processes of the Rhinobasis.- Follow up of Visual Defects After Optic Nerve Decompression.- Oculomotor, Trochlear and Abducens Nerves.- Angiographic Aspects of the Arterial Supply of the Cranial Nerves.- Ophtalmologie Diagnosis.- Electrophysiological Diagnosis.- EMG Differential Diagnosis in Case of Abducens Nerve Paresis.- Pathomechanism of Oculomotor and Abducens Paresis in Supra- and Infratentorial Processes.- Disturbances of Ocular Movement Due to Cerebral Aneurysm — Based Upon the Experience in 1000 Directly Operated Patients.- Incidence and Prognosis of Oculomotor Palsy After Subarachnoid Hemorrhage Due to Ruptured Aneurysms of the Posterior Communicating Artery.- Intracranial Compression of the Third, Fourth, and Sixth Cranial Nerves by Tumors.- Tumor Compression of Oculomotor, Trochlear and Abducens Nerve in Cavernous Sinus and Orbit.- Paralysis of the Extraocular Muscles in Tumors of the Sella Turcica Region.- N. VI Palsy in Cerebrovascular Disease.- Trigeminal Nerve (Fifth Cranial Nerve).- Specialized Features of the Trigeminal Nerve and Its Central Connections.- Neurophysiological Diagnosis of Trigeminal Nerve Function.- The Pathophysiology of Trigeminal Neuralgia.- Symptomatic Trigeminal Neuralgia.- Percutaneous Controlled Thermocoagulation of Gasserian Ganglion in Trigeminal Neuralgia. Experiences with 1000 Cases.- Vascular Decompression in Trigeminal Neuralgia.- Critical Remarks on Different Surgical Methods in Trigeminal Neuralgia.- Alteration of Sensibility in Trigeminal Neuralgia Before and After Selective Section of the Root by Posterior Approach.- Reconstruction of the Trigeminal Nerve.- Trigeminal Paresthesias in Cervical 5/6 Disk Involvement.- Facial and Vestibulo-Chochlear Nerves (Seventh and Eighth Cranial Nerves).- Facial and Vestibulocochlear Nerve, Topographic Anatomy and Variations.- Microsurgical Anatomy of the Arterial Loops in the Ponto-Cerebellar Angle and the Internal Acoustic Meatus.- Variations of the Course of the Facial Nerve in the Middle Ear and Mastoid.- Intraneural Topography of the Extracranial Facial Nerve.- Distribution of the Nerve Fibres in the Extra-Temporal Branches of the Facial Nerve.- Clinical Aspects of Facial Nerve.- Clinical Diagnosis in Bell’s Palsy.- Functional Testing of the Facial Nerve.- Neurophysiological Diagnosis of Facial Nerve.- Indications and Operative Technique for Endoscopy of the Cerebellopontine Angle.- Preservation and Reconstruction of the Facial Nerve in the Cerebellopontine Angle.- Facial Nerve Preservation in Acoustic Neuroma Surgery. Comparison Between Trans-Temporal and Retro-Sigmoid Approaches.- Microsurgery of the Extratemporal Portion of the Facial Nerve.- Neurosynthesis of the Facial Nerve; Electrical vs. Clinical Results.- Documentation and Evaluation of the Results.- Management of Hemi-Facial Spasm.- Hemifacial Spasm.- The Pathogenesis of Hemifacial Spasm: Characteristic Changes of Vasculatures in Vertebro-Basilar Artery System.- Surgical Treatment of Hemifacial Spasm.- Bells Palsy.- Infusion Therapy — A New Concept in Treatment of Bell’s Palsy.- Anastomosis of the Facial Nerve with Accessory or Hypoglossal Nerves.- Facio-Facial-Anastomosis.- Cochleo-Vestibular Nerve.- Audiological Findings in Retrocochlear Lesions.- Functional Testing of the Vestibular Nerve.- Early Diagnosis of Eighth Cranial Nerve Lesions by Positional Testing and Meatography.- Neurectomy of the Vestibular Nerve for Menière’s Disease.- Neurovascular Cross-Compression of the Eighth Cranial Nerve in Patients with Vertigo and Tinnitus.- Early Experiences in Vascular Decompression for Vestibulo-Cochlear Malfunction.- Combination of Hearing Loss Blindness.- Preservation of Hearing in Acoustic Neurinoma Surgery.- Early Diagnosis and Transtemporal Removal of Small Nerve VII and VIII Tumors.- Reversible Functional Damage of VIIIth Cranial Nerve in Arachnopathia Pontocerebellaris.- Retro-Sigmoid Approach for Preservation of Hearing in Early Acoustic Neuroma Surgery.- Preservation of Eighth Cranial Nerve in Cerebello-Pontine Angle Tumors.- Caudal Cranial Nerves.- Neurological Diagnosis of Caudal Cranial Nerves Lesions.- Endoscopic Electromyography and Neurography (Examination of the Inferior Cranial Motor Nerves: Nn. IX, X, XI, XII).- Surgical Management of the Caudal Cranial Nerves.- On the Pathogenesis, Treatment and Prognosis of Lesions of the Vagus Nerve.- Percutaneous and Selective Radiofrequency Thermocoagulation of Essential Glossopharyngeal Neuralgia.- Shunt-Operations for the Recurrent Laryngeal Nerve.- Functional Rehabilitation of the Denervated Larynx; Concept and Conequences.- Operative Treatment of Accessory Nerve Lesions.- Résumé and Future Perspectives of Surgery on Cranial Nerves.