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Acta Neurochirurgica
Published in: Acta Neurochirurgica 2/2019

01-02-2019 | How I Do it - Vascular Neurosurgery - Aneurysm

The modified retrosigmoid approach: a how I do it

Published in: Acta Neurochirurgica | Issue 2/2019

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Abstract

Background

The traditional retrosigmoid (RS) approach provides limited exposure of the inferior compartment of the CPA, while radical skull base approaches are demanding and associated with significant morbidity.

Methods

This study outlines the relevant surgical anatomy and the different surgical steps of a modified retrosigmoid (MRS) approach.

Results

The MRS provides enhanced exposure of the CPA and deep vascular structures resulting from a modified RS craniotomy and limited exposure of the sigmoid sinus.

Conclusion

In selected posterior fossa lesions, this cisternal approach is a straightforward corridor that can be routinely performed as a safe alternative to radical cranial base approaches.
Appendix
Available only for authorised users
Literature
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Matsushima K, Kohno M, Komune N, Miki K, Matsushima T, Rhoton AL Jr (2014) Suprajugular extension of the retrosigmoid approach: microsurgical anatomy. J Neurosurg 121(2):397–407CrossRefPubMed
2.
Quinones-Hinojosa A, Chang EF, Lawton MT (2006) The extended retrosigmoid approach: an alternative to radical cranial base approaches for posterior fossa lesions. Neurosurgery 58:ONS-208–ONS-214 discussion ONS-214
3.
Raza SM, Quinones-Hinojosa A (2011) The extended retrosigmoid approach for neoplastic lesions in the posterior fossa: technique modification. Neurosurg Rev 34:123–129CrossRefPubMed
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Rodriguez-Hernandez A, Lawton MT (2011) Anatomical triangles defining surgical routes to posterior inferior cerebellar artery aneurysms. J Neurosurg 114:1088–1094CrossRefPubMed
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Rodriguez-Hernandez A, Rhoton AL Jr, Lawton MT (2011) Segmental anatomy of cerebellar arteries: a proposed nomenclature. J Neurosurg 115:387–397CrossRefPubMed
Metadata
Title
The modified retrosigmoid approach: a how I do it
Publication date
01-02-2019
Published in
Acta Neurochirurgica / Issue 2/2019
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-018-3764-9

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