Matsushima Ken, Kohno Michihiro
Department of Neurosurgery, Tokyo Medical University.
No Shinkei Geka. 2022 May;50(3):625-633. doi: 10.11477/mf.1436204595.
The lateral suboccipital retrosigmoid approach is one of the most established approaches for accessing the posterior cranial fossa. In order to expand the surgical field, several extensions, including(1)extended craniotomy(e.g., far lateral, transcondylar, and transsigmoid approaches), (2)additional intradural osseous or bony drilling(e.g., transmeatal and suprajugular approaches), and (3)fissure dissection(e.g., suprafloccular and infrafloccular approaches), have been described. In this report, we introduce our technique for the retrosigmoid approach and review several extensions as illustrated by schwannoma, meningioma, and epidermoid cyst surgeries.
枕下外侧乙状窦后入路是进入后颅窝最常用的入路之一。为了扩大手术视野，人们描述了几种扩展方法，包括（1）扩大开颅术（如远外侧、经髁和经乙状窦入路），（2）额外的硬膜内骨质切除或骨钻孔（如经耳道和颈静脉上入路），以及（3）脑沟分离（如绒球上和绒球下入路）。在本报告中，我们介绍乙状窦后入路的技术，并回顾几种扩展方法，这些方法在神经鞘瘤、脑膜瘤和表皮样囊肿手术中得到了体现。
