Suboccipital Lateral Approaches (Presigmoid)

  • Luciano Mastronardi
  • Alessandro Ducati
  • Takanori Fukushima


The goal of presigmoid approaches is to expose the posterior cranial fossa via partial or complete petrosectomy and division of the tentorium. The presigmoid approaches are an anterior extension of the common suboccipital lateral approach, and provide excellent exposure of cerebellopontine angle and pons. We generally distinguish three types of presigmoid approaches, namely the retrolabyrinthine, the translabyrinthine and the transcochlear, that represent three progressive steps of the petrosectomy.


Facial Nerve Sigmoid Sinus Jugular Bulb Lateral Semicircular Canal Fallopian Canal 
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  1. 1.
    Bambakidis NC, Gonzalez F, Amin-Hanjani S et al (2005) Combined skull base approaches to the posterior fossa. Technical note. Neurosurg Focus 19:E6Google Scholar
  2. 2.
    Erkmen K, Pravdenkova S, Al-Mefty O (2005) Surgical management of petroclival meningiomas: factors determining the choice of approach. Neurosurg Focus 15:E7Google Scholar
  3. 3.
    Fukushima T, Sameshima T, Friedman A (2006) Manual of skull base dissection, 2nd edn. AF Neurovideo, RaleighGoogle Scholar
  4. 4.
    Sameshima T, Mastronardi L, Friedman A, Fukushima T (eds) (2007) Fukushima’s microanatomy and dissection of the temporal bone for surgery of acoustic neuroma, and petroclival meningioma, 2nd edn. AF Neurovideo, Raleigh, pp 84–114Google Scholar
  5. 5.
    Tummala RP, Coscarella E, Morcos JJ (2005) Combined skull base approaches to the posterior fossa. Neurosurg Focus 19:E6CrossRefPubMedGoogle Scholar
  6. 6.
    Ammirati M, Samii M (1992) Presigmoid sinus approach to petroclival meningiomas. Skull Base Surg 2:124–128CrossRefPubMedGoogle Scholar
  7. 7.
    Aristegui M, Canalis RF, Naguib M et al (1997) Retrolabyrinthine vestibular nerve section: a current appraisal. Ear Nose Throat J 76:578–583PubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2010

Authors and Affiliations

  • Luciano Mastronardi
    • 1
  • Alessandro Ducati
    • 2
  • Takanori Fukushima
    • 3
    • 4
    • 5
  1. 1.Dept of Neurosurgery, Sant’Andrea Hospital“Sapienza” University of RomeItaly
  2. 2.Department of NeurosurgeryUniversity of TorinoItaly
  3. 3.Carolina Neuroscience Institute for Skull Base SurgeryRaleigh
  4. 4.Duke UniversityDurham
  5. 5.University of MorgantownUSA

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