The Modified Concorde Position with an Intraoperative Skew Head Rotation: Technical Note

Area of Science:

• Neurosurgery
• Surgical Techniques
• Cranial Surgery

Background:

• The Concorde position is a standard neurosurgical approach for accessing pineal and cerebellar lesions via a midline suboccipital craniotomy.
• A neutral head position is crucial for symmetrical occipital muscle division during this procedure.
• Current methods for achieving the Concorde position can involve difficult intraoperative head repositioning.

Purpose of the Study:

• To describe a novel, simplified technique for achieving the Concorde position in neurosurgery.
• To enhance surgical convenience and accuracy during procedures involving pineal and cerebellar lesions.
• To address the limitations of intraoperative head repositioning in the traditional Concorde method.

Main Methods:

• A modified head fixation strategy using the Sugita head holder was developed.
• The technique involves asymmetric head fixation to achieve a skew head rotation.
• This method facilitates optimal patient positioning for both the craniotomy and subsequent microscopic procedures.

Main Results:

• The modified skew head rotation technique proved quick and convenient for achieving the desired patient head position.
• This approach simplifies intraoperative adjustments, overcoming the difficulties associated with releasing the head holder in the original method.
• The technique ensures an optimal head position for accurate surgical manipulation.

Conclusions:

• A modified asymmetric head fixation technique offers a more efficient and convenient way to achieve the Concorde position.
• This simplified approach improves surgical workflow and patient positioning for midline suboccipital craniotomies.
• The described method enhances the practicality of the Concorde position for neurosurgical interventions.