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How I do it: combined petrosectomy

  • Shunya Hanakita
  • Kentaro Watanabe
  • Pierre-Olivier Champagne
  • Sébastien FroelichEmail author
How I Do it - Neurosurgery general
Part of the following topical collections:
  1. Neurosurgery general

Abstract

Background

Petroclival lesions are among the most complex to address in skull base surgery, being closely related to critical neurovascular structures and brainstem. The combined petrosectomy allows a wide exposure of large petroclival lesions with short working distance and provides multiple angles of attack, while limiting brain retraction.

Method

We describe in a step-wise fashion the surgical steps of the combined petrosectomy.

Conclusion

Combined petrosectomy with posterior transposition of the transverse-sigmoid sinus provides a wide surgical corridor to the ventral brainstem, middle and upper clivus, and infra-retrochiasmatic region.

Keywords

Anterior petrosectomy Combined petrosectomy Petroclival region Posterior petrosectomy Skull base surgery 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Patient consent

The patient has consented to the submission of this How I Do It for submission to the journal.

Supplementary material

701_2019_4022_MOESM1_ESM.mov (263.3 mb)
Operative video demonstrating the major steps described in this work to perform the combined petrosectomy (MOV 269654 kb)

References

  1. 1.
    Al-Mefty O, Fox JL, Smith RR (1988) Petrosal approach for petroclival meningiomas. Neurosurgery 22:510–517CrossRefGoogle Scholar
  2. 2.
    Hakuba A, Nishimura S, Jang BJ (1988) A combined retroauricular and preauricular transpetrosal-transtentorial approach to clivus meningiomas. Surg Neurol 30:108–116CrossRefGoogle Scholar
  3. 3.
    Haq IB, Susilo RI, Goto T, Ohata K (2016) Dural incision in the petrosal approach with preservation of the superior petrosal vein. J Neurosurg 124:1074–1078CrossRefGoogle Scholar
  4. 4.
    Troude L Jr, Carissimi M Jr, Lavieille JP, Roche PH (2016) How I do it: the combined petrosectomy. Acta Neurochir 158:711–715CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Shunya Hanakita
    • 1
  • Kentaro Watanabe
    • 1
  • Pierre-Olivier Champagne
    • 1
  • Sébastien Froelich
    • 1
    Email author
  1. 1.Department of Neurosurgery, Lariboisière Hospital, Assistance Publique – Hôpitaux de ParisParis Diderot UniversityParisFrance

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