title: The far lateral/combined supra- and infratentorial approach. A human cadaveric prosection model for routes of access to the petroclival region and ventral brain stem.
abstract: A far lateral approach to the ventral brain stem, lower clivus, and anterior foramen magnum is described. Methods for further exposure of the superior petroclival region by incorporating a subtemporal craniotomy and posterior petrosectomy are also demonstrated. Eight sequentially illustrated steps depict this technique. The far lateral/combined supra- and infratentorial exposure is a comprehensive surgical approach that provides direct access to the entire anterior and lateral brain stem and craniovertebral junction. It minimizes brain-stem retraction and maximizes visualization of the neurovascular structures.
authors.affiliation: Department of Neuro-Otology, Barrow Neurological Institute, Phoenix, Arizona.
authors.forename: H Z
authors.initials: HZ
authors.lastname: Baldwin
authors.forename: C G
authors.initials: CG
authors.lastname: Miller
authors.forename: H R
authors.initials: HR
authors.lastname: van Loveren
authors.forename: J T
authors.initials: JT
authors.lastname: Keller
authors.forename: C P
authors.initials: CP
authors.lastname: Daspit
authors.forename: R F
authors.initials: RF
authors.lastname: Spetzler
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation; D001933:Brain Stem / Q000033:anatomy & histology* / Q000601:surgery*; D002102:Cadaver; D001270:Cervical Atlas / Q000033:anatomy & histology / Q000601:surgery; D002574:Cervical Vertebrae / Q000033:anatomy & histology / Q000601:surgery; D003388:Cranial Fossa, Posterior / Q000033:anatomy & histology* / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D004388:Dura Mater / Q000033:anatomy & histology / Q000601:surgery; D005206:Fascia Lata / Q000637:transplantation; D005539:Foramen Magnum / Q000033:anatomy & histology / Q000601:surgery; D006801:Humans; D009777:Occipital Bone / Q000033:anatomy & histology / Q000601:surgery; D010579:Petrous Bone / Q000033:anatomy & histology* / Q000601:surgery*; D011187:Posture; D013701:Temporal Bone / Q000033:anatomy & histology / Q000601:surgery; D014711:Vertebral Artery / Q000033:anatomy & histology / Q000601:surgery; D015050:Zygoma / Q000033:anatomy & histology / Q000601:surgery