Surgical Anatomy and Clinical Complications of Presigmoid Approach

Year 2018, Volume: 44 Issue: 1, 33 - 40, 01.05.2018

Rövşen Bagirov Mevlüt Özgür Taşkapılıoğlu , Selçuk Yılmazlar

https://doi.org/10.32708/uutfd.429459

Abstract

Presigmoid approaches are used for lateral access to the upper and middle third of the clivus and the petrous apex. These approaches provide anterolateral visualization of the brain stem after mobilization of the transvers-sigmoid sinus junction. In comparison to classical subtemporal or paramedian suboccipital approaches, these skull base approaches provide safer and wider surgical access to petroclival region lesions and enable more complete resections. In dealing with tumors in the petroclival region the main goal is maximal safe resection. The complications due to presigmoid approaches are generally temporary and manageable.

Keywords

Skull base tumors, Posterior fossa, Petrous bone, Presigmoid approach

Presigmoid Yaklaşımda Cerrahi Anatomi ve Klinik Komplikasyonlar

Abstract

Presigmoid girişimler klivusun üst 1/3 ve orta 1/3 bölümlerine ve petröz apekse lateralden yaklaşım için kullanılan girişimlerdir. Bu girişimler transvers-sigmoid sinüs bileşkesini mobilize ederek beyin sapına anterolateralden bakışı mümkün kılarlar. Bu kafa tabanı girişimleri klasik subtemporal ve suboksipital paramediyan girişimlere kıyasla daha geniş bir cerrahi koridor sağlar ve petroklival bölge lezyonlarında daha yüksek oranlarda total rezeksiyonu mümkün kılarlar. Oluşan komplikasyonlar sıklıkla geçici ve tedavi edilebilir olaylardır.

Keywords

Kafa tabanı tümörleri, Posterior fossa, Petröz kemik, Presigmoid yaklaşım

References

• 1. Tjahjadi M, Niemelä M, Kivelev J, et al. Presigmoid Approach to Vertebrobasilar Artery Aneurysms: A Series of 31 Patients and Review of the Literature. World Neurosurg. 2016;92:313-22.
• 2. Gross BA, Tavanaiepour D, Du R, Al-Mefty O, Dunn IF. Petrosal approaches to posterior circulation aneurysms. Neuro-surg Focus. 2012;33:E9
• 3. Lin H, Zhao G. A comparative anatomic study of a modified temporal-occipital transtentorial transpetrosal-ridge approach and transpetrosal presigmoid approach. 2011;75(3-4):495-502
• 4. Kawase T. Advantages and disadvantages of surgical approac-hes to petroclival lesions. World Neurosurg. 2011;75(3-4):421
• 5. Ohata K, Haque M, Morino M, Nagai K, Nishio A, Nishijima Y, et al. Occlusion of the sigmoid sinus after surgery via the pre-sigmoidal-transpetrosal approach. J Neurosurg. 1998;89:575-84
• 6. Keiper GL Jr, Sherman JD, Tomsick TA, Tew JM Jr. Dural sinus thrombosis and pseudotumor cerebri: unexpected compli-cations of suboccipital craniotomy and translabyrinthine crani-ectomy. J Neurosurg. 1999;91:192-97.
• 7. Frič R, Eide PK. The presigmoid approach for removal of tumours causing ventral compression of the brainstem. Surgical results and postoperative quality of life. Br J Neurosurg. 2011;25(1):86-93.
• 8. Gonzalez LF, Amin-Hanjani S, Bambakidis NC, Spetzler RF. Skull base approaches to the basilar artery. Neurosurg Focus. 2005;19:E3
• 9. Gross BA, Tavanaiepour D, Du R, Al-Mefty O, Dunn IF. Evolution of the posterior petrosal approach. Neurosurg Focus. 2012;33:E7.
• 10. Aziz KM, van Loveren HR, Tew JM Jr, Chicoine MR. The Kawase approach to retrosellar and upper clival basilar aneurysms. Neurosurgery.1999;44:1225-34.