Abstract
Background
Petroclival and ventral brain stem tumors require a complex approach.
Method
The combined petrosectomy is an epidural transtentorial-transpetrosal otoneurosurgical approach to achieve a retrolabyrinthine presigmoidal approach and an anterior petrosectomy in one single procedure. The different steps of this approach are described and illustrated by figures and a video. The indications and limitations of the technique are presented.
Conclusion
The combined petrosectomy offers multiple corridors to the petroclival region and ventral brainstem while preserving the intrapetrous neurotological structures. Meticulous stepwise bony resection optimizing the dural opening and preservation of veins contributes to reducing the risk inherent to this technique.
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Abbreviations
- CP:
-
combined petrosectomy
- IAC:
-
internal auditory canal
- IPS:
-
inferior petrosal sinus
- MC:
-
Meckel’s cave
- SCC:
-
semicircular canal
- SPS:
-
superior petrosal sinus
- SS:
-
sigmoid sinus
- TS:
-
transverse sinus
References
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None of the authors have any conflict of interest or financial disclosure in relation to this study. The manuscript has not been previously published in whole or in part or submitted elsewhere for review.
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Intraoperative video
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Microsurgical resection of a right-sided petroclival meningioma via a combined petrosectomy approach.
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Troude, L., Carissimi, M., Lavieille, JP. et al. How I do it: the combined petrosectomy. Acta Neurochir 158, 711–715 (2016). https://doi.org/10.1007/s00701-016-2740-5
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DOI: https://doi.org/10.1007/s00701-016-2740-5