Ito M, Kinoshita A, Takemoto O, Kohmura E, Hayakawa T
Department of Neurosurgery, Osaka University Medical School, Japan.
Surg Neurol. 1995 Apr;43(4):360-2. doi: 10.1016/0090-3019(95)80064-n.
The conventional method for performing superficial temporal artery to superior cerebellar artery (STA-SCA) anastomosis is applied to ischemic lesions in the posterior circulation via the temporobasal approach. However, this approach can be difficult and presents limitations due to the deep and narrow surgical field.
STA-SCA anastomosis using the presigmoid retrolabyrinthine transtentorial approach was performed, in which a large skin incision was required for the isolation of the STA, compared to that associated with the petrosal approach as described in previous reports. The superior petrosal sinus was sacrificed, and the tentorium cerebelli was cut up to the level of the incisula. Being very close to the surface opening, the SCA was approached easily at the ambient portion without any danger to the vein of Labbe. The SCA ran perpendicularly upward in the surgical field, which was advantageous in performing the anastomosis.
The presigmoid retrolabyrinthine transtentorial approach may provide a better surgical strategy than the temporobasal approach in performing STA-SCA anastomosis.
进行颞浅动脉至小脑上动脉（STA-SCA）吻合术的传统方法是通过颞底部入路应用于后循环的缺血性病变。然而，由于手术视野深且窄，这种入路可能具有难度并存在局限性。
采用乙状窦前迷路后经小脑幕入路进行STA-SCA吻合术，与既往报道的岩骨入路相比，该入路在分离STA时需要更大的皮肤切口。牺牲岩上窦，并将小脑幕切开至岩下窦水平。由于非常靠近表面开口，在环池部很容易接近SCA，且对Labbe静脉没有任何危险。SCA在手术视野中垂直向上走行，这有利于进行吻合术。
在进行STA-SCA吻合术时，乙状窦前迷路后经小脑幕入路可能比颞底部入路提供更好的手术策略。
