Akademik Veri Yönetim Sistemi
Ankara Üniversitesi Tıp Fakültesi Mecmuası, cilt.76, sa.1, ss.70-74, 2023 (Hakemli Dergi)
Objectives: In neurosurgical practice, retrosigmoid craniotomy (RC) is mostly performed to gain access of the posterolateral skull base area. The close relationship of the sigmoid sinus (SS) and transverse sinus (TS) is critical for craniotomy related sinus injury. Previous studies have evaluated preoperative identification of TS and SS to provide appropriate surgical location and achieve a safe approach. We aimed to perform the safest and simplest craniotomy technique to avoid sinus injury and minimise bone removal. In this article, we described our modified RC technique. Materials and Methods: Data of 27 patients who underwent a safe RC were retrospectively evaluated. All procedures were performed by the same senior and junior surgeons. Patient with recurrent surgery and craniofacial bone anomaly were excluded from the study. Results: The mean age of the patients was 57.41±8.75 years, 15 (55.56%) patients were male and 12 (44.44%) were female. Moreover, 15 patients had vestibular schwannoma, nine had petrous ridge meningioma and three had an epidermoid tumour. The procedure was performed in 25 patients with cerebellopontine angle (CPA) lesions and in two patients with brainstem lesions. Cerebrospinal fluid leakage was found in 2 (7.41%) patients postoperatively, and all of them were treated conservatively. None of the patients had sinus injury, bone flattening or cosmetic failure related to RC technique. Conclusion: We described our experience with the modified safe RC technique for CPA tumours. A 3×3 cm size safe oblique RC technique with exposure of the 1/4 medial border of the SS and transverse SS junction is satisfactory enough for all of our cases. Our modified RC technique is a safe and easily performed surgical approach that can be used in CPA, brainstem lesions and vascular pathologies. Nevertheless, this technique minimizes unnecessary bone removal and extra cerebellar retraction are not needed because of the small craniotomy sizes.