Suboccipital Lateral Approaches (Retrosigmoid)

  • Madjid Samii
  • Venelin M. Gerganov


The lateral suboccipital or the retrosigmoid approach (RSA) was developed by Fedor Krause and utilized for the first time by him in 1898. During the following decades it was developed and became one of the main and most frequently applied operative approaches in neurosurgery [1, 2, 3, 4, 5]. Various pathological entities located in the cerebellopontine angle (CPA), the internal auditory canal (IAC), the petroclival area, and the lateral or anterior foramen magnum area, can be adequately accessed via the classical RSA or some of its modifications. Refinements of the operative technique led to a significant decrease in the initially high procedure-related complication rate, and nowadays the RSA is safe and relatively easy to perform. Due to the wide panoramic view offered by the approach, all stages of surgery may be performed under direct visual control, which is particularly important during dissection in proximity of the brainstem. Further, in patients with a large vestibular schwannoma (VS), the RSA is the only hearing-sparing technique.


Vestibular Schwannoma Transverse Sinus Acoustic Neuroma Internal Auditory Canal Vestibular Schwannomas 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Italia 2010

Authors and Affiliations

  • Madjid Samii
    • 1
  • Venelin M. Gerganov
    • 1
  1. 1.International Neuroscience InstituteHannoverGermany

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