Modified orbitozygomatic craniotomy with a single burr hole in the alternative sphenoid ridge keyhole.

Background: One-piece modified orbitozygomatic approach (OZA) is an extended version of the pterional approach that also includes orbital walls and frontal process of the zygomatic bone. For this craniotomy one burr hole must be placed in MacCarty keyhole and another - in the temporal region.

Objective: To develop a technique of the one-piece modified OZA with single a burr hole in the alternative sphenoid ridge keyhole that allows access to orbit, anterior cranial fossa and middle cranial fossa and apply it intraoperatively.

Mediastinitis due to Cervical Osteophytes in a Patient after Hemithyroidectomy.

Descending necrotising mediastinitis is a terrible disease, usually a complication of an inflammatory process of the pharynx, pathology of the mandibular or submandibular space. The development of mediastinitis in a patient after haemithyroidectomy under general anaesthesia with tracheal intubation due to esophagus injury is a very rare condition. Our patient's early post-operative period was complicated by severe pain behind the sternum not associated with acute coronary syndrome.