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Posts Tagged ‘Retrosigmoid approach

Ahead of Print: Dural Landmark To Locate the Internal Auditory Canal in Large and Giant Vestibular Schwannomas: the Tubingen Line

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BACKGROUND: In cases of large and giant vestibular schwannomas (VS), the visualization of the internal auditory canal (IAC) opening is difficult or impossible.

OBJECTIVE: To describe the Tubingen line and explores its relationships with the IAC as a landmark to help locate the IAC.

METHODS: Ten cadaveric heads were used in this study. Between 2004 and 2009, the senior author (MT) used the Tubingen line as a landmark to recognize the IAC in 300 consecutive patients with VS. To locate the Tubingen line, the initial step was to identify several vertical foldings of dura located around the area of the vestibular aqueduct. Following this, foldings upward consistently reached a linear level where all of the foldings ended and the dura tightly adhered to the bony surface in a smooth, foldless shape.

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Written by NEUROSURGERY® Editorial Office

June 6, 2011 at 3:00 PM

Editor Choice: Critical Assessment of Operative Approaches for Hearing Preservation in Small Acoustic Neuroma Surgery: Retrosigmoid Vs Middle Fossa Approach

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Sameshima, Tetsuro MD, PhD; Fukushima, Takanori MD, DMSc; McElveen, John T. Jr MD; Friedman, Allan H. MD

BACKGROUND: For hearing preservation in acoustic neuroma (AN) surgery, the middle fossa (MF) or retrosigmoid (RS) approach can be used. Recent literature advocates the use of the MF approach, especially for small ANs.

OBJECTIVE: To present our critical analysis of operative results comparing these 2 approaches.

METHODS: We reviewed 504 consecutive AN resections performed between November 1998 and September 2007 and identified 43 MF and 82 RS approaches for tumors smaller than 1.5 cm during hearing preservation surgery. Individual cases were examined postoperatively with respect to hearing ability, facial nerve activity, operative time, blood loss, and symptoms resulting from retraction of the cerebellar or temporal lobes.

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Written by NEUROSURGERY® Editorial Office

September 20, 2010 at 9:08 AM


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