Image-guided lateral suboccipital approach: part 1-individualized landmarks for surgical planning

Neurosurgery
A GharabaghiMadjid Samii

Abstract

Being situated close to the transverse and sigmoid sinus, the asterion has traditionally been viewed as a landmark for surgical approaches to the posterior fossa. Cadaveric studies, however, have shown its variability in relation to underlying anatomic structures. We have used an image-guidance technology to determine the precise anatomic relationship between the asterion and the underlying transverse-sigmoid sinus transition (TST) complex in patients scheduled for posterior fossa surgery. The applicability of three-dimensional (3-D) volumetric image-rendering for presurgical anatomic identification and individualization of a surgical landmark was evaluated. One-millimeter computed tomographic slices were combined with venous computed tomographic angiography in 100 patients, allowing for 3-D volumetric image-rendering of the cranial bone and the dural vasculature at the same time. The spatial relationship between the asterion and the TST was recorded bilaterally by using opacity modulation of the bony surface. The location of both the asterion and the TST could be confirmed during surgery in all of these patients. It was possible to accurately visualize the asterion and the sinuses in a single volumetrically rendered 3-D image ...Continue Reading

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Citations

Aug 1, 2012·PloS One·Eduard H J VoormolenJan Willem Berkelbach van der Sprenkel
Nov 11, 2009·Acta neurochirurgica·Erasmo Barros da SilvaRicardo Ramina
Jan 20, 2017·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Zsolt ZadorIan D Kamaly-Asl
Jan 5, 2018·Operative Neurosurgery·Juergen GrauvogelChristian Scheiwe
Feb 20, 2020·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·M Travis CatonDiego Nunez

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