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Combined Surgical Approaches

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Surgery of the Cerebellopontine Angle

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Abstract

The decision regarding which surgical approach to use during exposure of the posterior fossa requires careful analysis by surgeons. The degree of exposure required is critical in determining the optimum route of attack. The need to visualize the lesion and surrounding eloquent structures adequately so that resection can be undertaken safely must be weighed against the potential complications associated with each type of approach. In the axial plane, the skull-base of the posterior fossa can be exposed through multiple directions broadly classified as posterior or lateral approaches (Fig. 6.1a). In the sagittal plane, the options include supratentorial or infratentorial directions (Fig. 6.1b). In both cases, combinations of these approaches may allow the greatest degree of exposure. This strategy maximizes the potential for safe surgical resection of the pathology in question while limiting potential risks to the patient.

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Acknowledgments

The authors thank Mark Schornak, Spencer Phippen, Deborah Ravin, and Stephen Harrison for their anatomical drawings.

Author information

Authors and Affiliations

  1. Neurological Surgery, The Neurological Institute, University Hospitals of Cleveland, Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Nicholas C. Bambakidis

  2. Comprehensive Brain Tumor Program, Neurosurgery, Stephenson Cancer Center, University of Oklahoma School of Medicine, Oklahoma City, OK, USA

    Chad A. Glenn

  3. Flagstaff Neurosurgery, Flagstaff, AZ, USA

    Sam Safavi-Abbasi

  4. Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA

    Robert F. Spetzler

Authors
  1. Nicholas C. Bambakidis
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  2. Chad A. Glenn
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  3. Sam Safavi-Abbasi
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  4. Robert F. Spetzler
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Corresponding author

Correspondence to Nicholas C. Bambakidis .

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Editors and Affiliations

  1. Chair of Neurological Surgery, Vice President and Director, The Neurological Institute, University Hospitals of Cleveland, Cleveland, OH, USA

    Nicholas C. Bambakidis

  2. Chief Executive Officer, University Hospitals Health System, Jane and Henry Meyer Distinguished CEO, Endowed Chair, Professor of Otolaryngology Head and Neck Surgery, Professor of Neurological Surgery, Case Western Reserve University, School of Medicine, Cleveland, OH, USA

    Cliff A. Megerian

  3. Emeritus President and CEO, Emeritus Chair, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA

    Robert F. Spetzler

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Bambakidis, N.C., Glenn, C.A., Safavi-Abbasi, S., Spetzler, R.F. (2022). Combined Surgical Approaches. In: Bambakidis, N.C., Megerian, C.A., Spetzler, R.F. (eds) Surgery of the Cerebellopontine Angle. Springer, Cham. https://doi.org/10.1007/978-3-031-12507-2_6

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  • DOI: https://doi.org/10.1007/978-3-031-12507-2_6

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