The history of the combined supra- and infratentorial approach to the petroclival region

被引:18
|
作者
Grossi, Peter M. [1 ,3 ]
Nonaka, Yoichi [2 ]
Watanabe, Kentaro [2 ]
Fukushima, Takanori [1 ,2 ,3 ]
机构
[1] Duke Raleigh Hosp, Raleigh, NC USA
[2] Carolina Neurosci Inst, Raleigh, NC USA
[3] Duke Univ, Div Neurosurg, Durham, NC USA
关键词
combined approach; petrosal approach; petroclival meningioma; skull base approach; CEREBELLOPONTINE ANGLE; MENINGIOMAS; SURGERY;
D O I
10.3171/2012.6.FOCUS12141
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Lesions of the ventrolateral brainstem, clivus, and cerebellopontine angle pose significant challenges for surgeons, and the rate of morbidity and mortality from classic neurosurgical approaches has proven to be unacceptably high. Early attempts to expose this region consisted primarily of an extended suboccipital craniectomy, with opening of the tentorium and ligation of the sigmoid sinus for additional exposure. During the 1960s, technological innovations including the surgical microscope and the pneumatic drill allowed surgeons to gain additional exposure by removing more bone from the base of the skull. This let surgeons define combined infra- and supratentorial approaches, which rely less on brain retraction to resect these difficult tumors successfully. These approaches rely on a combined posterior mastoid approach with an anterior petrosectomy. The evolution of this approach is discussed in this paper. (http://thejns.org/doi/abs/10.3171/2012.6. FOCUS12141)
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页数:5
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