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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- CN:
-
Cranial nerve
- CSF:
-
Cerebrospinal fluid
- MRS:
-
Modified retrosigmoid approach
- PICA:
-
Postero-inferior cerebellar artery
- RS:
-
Retrosigmoid approach
- SS:
-
Sigmoid sinus
- TS:
-
Transverse sinus
References
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):397–407
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
Raza SM, Quinones-Hinojosa A (2011) The extended retrosigmoid approach for neoplastic lesions in the posterior fossa: technique modification. Neurosurg Rev 34:123–129
Rodriguez-Hernandez A, Lawton MT (2011) Anatomical triangles defining surgical routes to posterior inferior cerebellar artery aneurysms. J Neurosurg 114:1088–1094
Rodriguez-Hernandez A, Rhoton AL Jr, Lawton MT (2011) Segmental anatomy of cerebellar arteries: a proposed nomenclature. J Neurosurg 115:387–397
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest. The manuscript has not been previously published in whole or in part or submitted elsewhere for review.
Patient consent
The patient has consented to the submission of this How I Do It for submission to the journal.
Additional information
This article is part of the Topical Collection on Vascular Neurosurgery - Aneurysm
Electronic supplementary material
Rights and permissions
About this article
Cite this article
Troude, L., Bernard, F., Sy, E.C.N. et al. The modified retrosigmoid approach: a how I do it. Acta Neurochir 161, 417–423 (2019). https://doi.org/10.1007/s00701-018-3764-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00701-018-3764-9