title: Surgical procedure "simplified retrosigmoid approach" for C-P angle lesions.
abstract: Previously, we reported surgical results of the simplified retrosigmoid approach for vestibular nerve sectioning in the cases with intractable vertigo. Here, we introduce in details surgical procedures of the simplified retrosigmoid (also called "subasterional" here for simplification) approach developed by one of the authors (J.H.L.). This approach is to operate cerebello-pontine (C-P) angle lesions through a small upper lateral window below the transverse-sigmoid junction. The retroauricular 4-5 cm skin incision, triangular craniectomy 2 cm in width, dural opening and closure, special considerations, and reconstruction of the skull defect were outlined. The bony landmarks for triangle craniectomy below asterion were described in detail. The C-P angle was appropriately approached for microvascular decompression, removal of C-P angle tumors, and vestibular nerve resection. This subasterional approach was characterized by short operation time of 1-3 h and less postoperative discomforts compared to the conventional retrosigmoid approach.
authors.affiliation: Department of Neurosurgery, The Cleveland Clinic Foundation, Cleveland, OH, USA. yamashim@med.kanazawa-u.ac.jp
authors.forename: Tetsumori
authors.initials: T
authors.lastname: Yamashima
authors.forename: Joung H
authors.initials: JH
authors.lastname: Lee
authors.forename: Samuel
authors.initials: S
authors.lastname: Tobias
authors.forename: Chang-Hyun
authors.initials: CH
authors.lastname: Kim
authors.forename: Jong Hee
authors.initials: JH
authors.lastname: Chang
authors.forename: Jeong-Taik
authors.initials: JT
authors.lastname: Kwon
mesh_terms: D002526:Cerebellar Diseases / Q000601:surgery*; D002530:Cerebellopontine Angle / Q000601:surgery*; D006801:Humans; D019635:Neurosurgical Procedures / Q000379:methods*