Abstract
Objective: The surgical access to the clivus and the petrous apex is still a challenge. A combined approach is best fitted to lesions located in the middle and posterior cranial fossa. The approach described is centered on the petrous bone and requires an extensive bone resection; nevertheless, no osteoplastic bone flap is necessary. Methods: In contrast to approaches described before, the petrous bone is drilled away anterior to the sigmoid sinus more extensively, the sinus is unroofed. For exposure of the middle cranial fossa the petrous bone should be resected down to the roof of the external meatus, the total extent of the craniotomy is significantly smaller. Results and Conclusion: The surgical access as described above provides a wide operative field under preservation of important intracranial structures. This modified approach minimizes the cerebellar and temporal lobe retraction. The neural and vascular structures can be preserved under direct vision to the tumor. The blood supply is interrupted at the beginning of the operation.
Key words
Approach - Clivus - Cerbellopontine Angle - Subtemporal-Suboccipital
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Prof. Dr. A. Sepehrnia,M. D.,
U. Knopp,M. D.
Neurosurgical Department, University of Lübeck
Ratzeburger Allee 160
23538 Lübeck
Germany
Phone: +49-451-5002076 ·
Fax: +49-451-5006191
Email: Sepehrni@medinf.mu-luebeck.de
