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Approaches to the Cerebellopontine Angle

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Surgery of Cerebellopontine Lesions

Abstract

In this chapter, the three main operative approaches to the internal auditory canal and cerebellopontine angle—the retrosigmoid, the translabyrinthine, and the middle fossa approach—are discussed. The middle fossa approach is utilized usually in case of small tumors, in which there is an opportunity to preserve hearing, especially in those located mainly laterally within the IAC. The extended middle fossa approach is used in VSs with less than 1-cm extension into the cerebellopontine angle. The TL approach is used widely for removal of VSs when hearing preservation is not an issue. In combination with other approaches, it is used in various cranial base tumors. The retrosigmoid approach is a safe, elegant, and relatively simple technique, related to very low procedure-related morbidity rate. With small modifications, described in the corresponding chapters of this book, it provides access to all levels of the cerebellopontine angle and their related structures: the petroclival area, Meckel’s cave, and part of the middle cranial fossa; the internal auditory canal and posterior part of the petrous bone; the jugular foramen; and the craniocervical junction. The approach is among the most frequently utilized operative routes in neurosurgery.

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Authors and Affiliations

  1. International Neuroscience Institute INI, Hannover, Germany

    Madjid Samii

  2. Department of Neurosurgery, International Neuroscience Institute, Hannover, Germany

    Venelin Gerganov

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  1. Madjid Samii
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  2. Venelin Gerganov
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Samii, M., Gerganov, V. (2013). Approaches to the Cerebellopontine Angle. In: Surgery of Cerebellopontine Lesions. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35422-9_4

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  • DOI: https://doi.org/10.1007/978-3-642-35422-9_4

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