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Micro-Doppler for venous sinus localization in approaches to the cerebello-pontine angle

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Abstract

Background

Main anatomical landmarks of retrosigmoid craniotomy are transverse sinus (TS), sigmoid sinus (SS), and the confluence of both. Anatomical references and guidance based on preoperative imaging studies are less reliable in the posterior fossa than in the supratentorial region. Simple intraoperative real-time guidance methods are in demand to increase safety.

Methods

This manuscript describes the localization of TS, SS, and TS-SS junction by audio blood flow detection with a micro-Doppler system.

Conclusion

This is an additional technique to increase safety during craniotomy and dura opening, widening the surgical corridor to secure margins without carrying risks nor increase surgical time.

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Data Availability

Not applicable.

Abbreviations

CT:

Computed tomography

MRI:

Magnetic resonance imaging

RSA:

Retrosigmoid approach

TS:

Transverse sinus

SS:

Sigmoid sinus

References

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Author information

Authors and Affiliations

  1. Neurosurgery Department, Hospital Universitario Ramón y Cajal, Ctra. de Colmenar Viejo km. 9, 100 28034, Madrid, Spain

    Estrella Barrero Ruiz & Luis Ley Urzaiz

Authors
  1. Estrella Barrero Ruiz
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  2. Luis Ley Urzaiz
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Contributions

Design and conception by EB and LL. Manuscript drafted and illustrations created by EB. The final manuscript was approved by all authors.

Corresponding author

Correspondence to Estrella Barrero Ruiz.

Ethics declarations

Ethics approval

It was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments.

Consent to participate/consent for publication

The patient gave the consent for the use of the images for academic and scientific purposes.

Conflict of interest

The authors declare no competing interests.

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Supplementary information

Video. Descriptive video of the procedure we describe in an RSA in a patient with left trigeminal neuralgia. (MP4 210179 kb)

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Barrero Ruiz, E., Ley Urzaiz, L. Micro-Doppler for venous sinus localization in approaches to the cerebello-pontine angle. Acta Neurochir 165, 3467–3472 (2023). https://doi.org/10.1007/s00701-023-05821-1

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  • DOI: https://doi.org/10.1007/s00701-023-05821-1

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