Superficial temporal artery to superior cerebellar artery anastomosis via the presigmoid retrolabyrinthine transtentorial approach.
BACKGROUND
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.


RESULTS
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.


CONCLUSIONS
The presigmoid retrolabyrinthine transtentorial approach may provide a better surgical strategy than the temporobasal approach in performing STA-SCA anastomosis.
Ito
M
M
Department of Neurosurgery, Osaka University Medical School, Japan.
Kinoshita
A
A
Takemoto
O
O
Kohmura
E
E
Hayakawa
T
T
D000714:Anastomosis, Surgical / Q000379:methods; D002545:Brain Ischemia / Q000601:surgery; D002531:Cerebellum / Q000098:blood supply*; D002536:Cerebral Arteries / Q000601:surgery*; D006801:Humans; D013702:Temporal Lobe / Q000098:blood supply*