J Neurosurg. 2020 Mar 27;134(3):843-847. doi: 10.3171/2020.1.JNS193179. Print 2021 Mar 1.
The presigmoid approach (PSA) is selected to obtain more lateral access to cerebellopontine angle tumors, brainstem cavernous malformations, or vertebrobasilar artery aneurysms than the standard retrosigmoid approach. However, mastoidectomy for the PSA can be considered time-consuming and to carry a higher risk of complications due to the anatomical complexity of the region. The authors established a method of minimized mastoidectomy focused on exposing Trautmann's triangle as the corridor for the PSA while maximizing procedural simplicity and safety and maintaining a sufficient operative view. The authors present their method of minimized mastoidectomy in a cadaver dissection and operative cases, showing potential as a useful option for the PSA.
经乙状窦前入路（PSA）可获得比标准乙状窦后入路更外侧的入路，从而到达桥小脑角肿瘤、脑干海绵状血管畸形或椎基底动脉动脉瘤。然而，PSA 的乳突切除术可能被认为是耗时的，并且由于该区域的解剖结构复杂，并发症的风险更高。作者建立了一种最小化乳突切除术的方法，该方法的重点是暴露 Trautmann 三角作为 PSA 的通道，同时最大限度地简化和安全手术过程，并保持足够的手术视野。作者在尸体解剖和手术病例中展示了这种最小化乳突切除术的方法，显示了其作为 PSA 有用选择的潜力。
