Frontiers in Surgery (Feb 2023)

A simple combined approach using anterior transpetrosal and retrosigmoid approach: A case report

  • Ryota Tamura,
  • Ryo Ueda,
  • Kosuke Karatsu,
  • Taichi Sayanagi,
  • Kento Takahara,
  • Utaro Hino,
  • Takashi Iwama,
  • Hirotsugu Nogawa,
  • Masato Nakaya,
  • Takashi Horiguchi,
  • Masahiro Toda

DOI
https://doi.org/10.3389/fsurg.2023.1094387
Journal volume & issue
Vol. 10

Abstract

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BackgroundA combined transpetrosal approach (CTP) is often used for large lesions in the posterior cranial fossa (PCF). Although CTP provides a wide surgical corridor, it has complex and time-consuming bony work of mastoidectomy and cosmetic issues. Here, we describe a simple combined surgical technique to approach the supratentorial region, anterolateral surface of the brainstem, petroclival region, and foramen magnum by drilling only the petrous apex with a combination of retrosigmoid approach (RA).Clinical presentationA 27-year-old female was referred with extra-axial left cerebellopontine angle space-occupying epidermoid cyst extending to the prepontine cistern, anterior to the basilar artery, superior to the chiasma, and caudally to the foramen magnum. A one-stage surgical procedure using the anterior transpetrosal approach (ATP) and RA was performed after one-piece temporal-suboccipital craniotomy. These two approaches complemented each other well. Near-total removal was achieved.ConclusionA one-stage surgical procedure using ATP and RA provides the wider viewing and better visualization of the PCF with minimal technical difficulty.

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