Journal
JOURNAL OF NEUROSURGERY
Volume 134, Issue 3, Pages 843-847Publisher
AMER ASSOC NEUROLOGICAL SURGEONS
DOI: 10.3171/2020.1.JNS193179
Keywords
posterior petrosal approach; mastoidectomy; cerebellopontine angle tumor; brainstem cavernous malformation; vertebrobasilar artery aneurysm; surgical technique; skull base
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The authors proposed a method of minimized mastoidectomy focused on exposing Trautmann's triangle as the corridor for the PSA, aiming to simplify the procedure, enhance safety, and maintain an adequate operative view. This technique was demonstrated in cadaver dissections and operative cases, showing potential as a useful option for the PSA.
The presigmoid approach (PSA) is selected to obtain more lateral access to cerebellopontine angle tumors, brainstem cavernous malformations, or vertebrobasilar artery aneurysms than the standard retrosigmoid approach. However, mastoidectomy for the PSA can be considered time-consuming and to carry a higher risk of complications due to the anatomical complexity of the region. The authors established a method of minimized mastoidectomy focused on expos -ing Trautmann?s triangle as the corridor for the PSA while maximizing procedural simplicity and safety and maintaining a sufficient operative view. The authors present their method of minimized mastoidectomy in a cadaver dissection and operative cases, showing potential as a useful option for the PSA.
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