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Acta Neurochirurgica

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29-09-2023 | Craniotomy | How I Do it

Micro-Doppler for venous sinus localization in approaches to the cerebello-pontine angle

Authors: Estrella Barrero Ruiz, Luis Ley Urzaiz

Published in: Acta Neurochirurgica | Issue 11/2023

Abstract

Background

Main anatomical landmarks of retrosigmoid craniotomy are transverse sinus (TS), sigmoid sinus (SS), and the confluence of both. Anatomical references and guidance based on preoperative imaging studies are less reliable in the posterior fossa than in the supratentorial region. Simple intraoperative real-time guidance methods are in demand to increase safety.

Methods

This manuscript describes the localization of TS, SS, and TS-SS junction by audio blood flow detection with a micro-Doppler system.

Conclusion

This is an additional technique to increase safety during craniotomy and dura opening, widening the surgical corridor to secure margins without carrying risks nor increase surgical time.

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Graffeo CS, Peris-celda M, Driscoll CLW, Link MJ, Perry A, Carlstrom LP (2021) Anatomical step-by-step dissection of complex skull base approaches for trainees : surgical anatomy of the retrosigmoid approach. J Neurol Surg B 82:321–332. https://doi.org/10.1055/s-0039-1700513CrossRef

Hall S, Gan YP (2019) Anatomical localization of the transverse-sigmoid sinus junction : comparison of existing techniques. Surg Neurol Int 10(186):1–7. https://doi.org/10.25259/SNICrossRef

Jian Z, Sheng M, Li J, Li Y, Weng Z, Chen G (2022) Precise localization in craniotomy with a retrosigmoid keyhole approach : microsurgical anatomy and clinical study. Study Front Surg. 9:1–6. https://doi.org/10.3389/fsurg.2022.809098CrossRef

Rodriguez Rubio RR, Xie W, Vigo V et al (2021) Immersive surgical anatomy of the retrosigmoid approach. Cureus 13(6). https://doi.org/10.7759/cureus.16068

Tomasello F, Esposito F, Abbritti RV et al (2016) MVD for trigeminal neuralgia: a technical refinement for complication avoidance. World Neurosurg 94:26–31. https://doi.org/10.1016/j.wneu.2016.06.097CrossRefPubMed

Troude L, Bernard F, Cheikh Ndiaye Sy E, Roche P-H (2019) The modified retrosigmoid approach : a how I do it. Acta Neurochir (Wien) 161:417–423. https://doi.org/10.1007/s00701-018-3764-9CrossRefPubMed

Title: Micro-Doppler for venous sinus localization in approaches to the cerebello-pontine angle
Authors: Estrella Barrero Ruiz
Luis Ley Urzaiz
Publication date: 29-09-2023
Publisher: Springer Vienna
Keyword: Craniotomy
Published in: Acta Neurochirurgica / Issue 11/2023
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-023-05821-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Micro-Doppler for venous sinus localization in approaches to the cerebello-pontine angle

Abstract

Background

Methods

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Conclusion

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