Published in:
01-06-2021 | Craniotomy | How I Do it - Vascular Neurosurgery - Other
Sub-telo-velo-tonsillar approach to resect dorsal pons cavernoma through fourth ventricular floor opening: how I do it
Published in: Acta Neurochirurgica | Issue 6/2021
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Background
Dorsal pons cavernoma can be approached through telo-velar approach instead of transvermian approach, with lower risk of neurological deficits since it uses natural clefts to reach the floor of the fourth ventricle.
Materials and methods
We present our surgical technique for telo-velar approach to address pathologies of the dorsal pons, assisted by neuronavigation and neuromonitoring. This surgical technique is illustrated by a surgical video of a dorsal pons cavernoma.
Conclusion
Dorsal pons cavernomas can be reached through telo-velar approach after suboccipital midline craniotomy. The accurate patient positioning, cisternal dissection, and neuromonitoring use are mandatory to avoid neural injuries and identify the safe entry points into the brainstem.