Two-bone flap craniotomy for the transpetrosal-presigmoid approach to avoid a bony defect in the periauricular area after surgery on petroclival lesions: technical note

Neurosurg Rev. 2010 Jan;33(1):121-6. doi: 10.1007/s10143-009-0221-5.

Abstract

The authors describe a two-bone-flap craniotomy technique to avoid the bone defect caused by the transpetrosal-presigmoid approach. Briefly, this technique includes three steps. The first step is to elevate a temporoparietal bone flap located superiorly to the transverse and sigmoid sinuses. The second step is to dissect the transverse and sigmoid sinuses away from the bone by inserting a gelatin sponge. This maneuver provides hemostasis and protects the sinuses from injury. The third step is to cut a second bone flap including part of the temporal bone and the outer table of the mastoid bone with a high-speed drill system. After the operation, the two bone flaps are fixed in place with titanium osteosynthesis fixation material. This approach provides a simple, easy, and safe technique for the transpetrosal-presigmoid approach. The technique has been performed in 83 patients treated for petroclival neoplasms with excellent cosmetic results.

MeSH terms

  • Adult
  • Aged
  • Bone Plates
  • Cranial Sinuses / surgery
  • Craniotomy / methods*
  • Dura Mater / surgery
  • Female
  • Hemostasis
  • Humans
  • Intraoperative Complications / blood
  • Intraoperative Complications / prevention & control
  • Male
  • Mastoid / surgery
  • Meningioma / surgery
  • Middle Aged
  • Neurosurgical Procedures / methods*
  • Petrous Bone / surgery*
  • Posture
  • Skull / diagnostic imaging
  • Skull / surgery*
  • Surgical Equipment
  • Surgical Flaps*
  • Surgical Sponges
  • Temporal Bone / surgery
  • Titanium
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Titanium