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How I do it: the combined petrosectomy

  • How I Do it - Neurosurgical Techniques
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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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Authors and Affiliations

Authors

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Correspondence to Lucas Troude Jr.

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Conflict of interest

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.

Electronic supplementary material

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Intraoperative video

(MOV 243 mb)

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

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