Quantitative analysis of the working area and angle of attack for the retrosigmoid, combined petrosal, and transcochlear approaches to the petroclival region

Journal of Neurosurgery
Rungsak SiwanuwatnMark C Preul

Abstract

The authors quantitatively assessed the working areas and angles of attack associated with retrosigmoid (RS), combined petrosal (CP), and transcochlear (TC) craniotomies. Four silicone-injected cadaveric heads were bilaterally dissected using three approaches progressing from the least to the most extensive. Working areas were determined using the Optotrak 3020 system on the upper and middle thirds of the petroclivus and brainstem. Angles of attack were studied using the Elekta SurgiScope at the Dorello canal and the origin of the anterior inferior cerebellar artery (AICA). The TC approach provided significantly greater (p < 0.001) working areas at the petroclivus (755.6 +/- 130.1 mm2) and brainstem (399.3 +/- 68.2 mm2) than the CP (354.1 +/- 60.3 and 289.7 +/- 69.9 mm2) and RS approaches (292.4 +/- 59.9, 177.2 +/- 54.2 mm2, respectively). The brainstem working area associated with the CP approach was significantly larger (p < 0.001) than that associated with the RS route. There was no difference in the petroclival working area comparing the CP and RS approaches (p = 0.149). The horizontal and vertical angles of attack achieved using the TC approach were wider than those of the CP and RS at the Dorello canal and the origin of t...Continue Reading

References

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Citations

Jul 1, 2011·Neurosurgical Review·Tobias Alecio Mattei, Ricardo Ramina
Mar 2, 2011·Skull Base : Official Journal of North American Skull Base Society ... [et Al.]·Pakrit JittapiromsakMark C Preul
Oct 17, 2007·Journal of Neurosurgery·Sam Safavi-AbbasiMark C Preul
Jan 1, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Tie FangYongjie Li
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Jun 10, 2015·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Jun ZhangYan Jiang
Feb 27, 2016·Journal of Neurosurgery·Eberval Gadelha FigueiredoMark C Preul
Mar 31, 2009·Arquivos de neuro-psiquiatria·Eberval Gadelha FigueiredoManoel Jacobsen Teixeira
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Jun 8, 2018·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Lukas AnschuetzMarco Caversaccio
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Aug 2, 2019·The Journal of Craniofacial Surgery·Alper VatanseverIlkan Tatar
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Mar 26, 2009·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Antonio De la Cruz, Karen B Teufert
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Jun 3, 2014·Neurosurgery·Eberval Gadelha FigueiredoMark C Preul
Dec 6, 2019·Neurosurgical Review·Rafael Martínez-PérezDaniel M Prevedello

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Methods Mentioned

BETA
dissection

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