title: Combined pre- and retrosigmoid approach for petroclival meningiomas with the aid of a rotatable head frame: peri-auricular three-quarter twist-rotation approach: technical note.
abstract: We used the combined subtemporal presigmoid and suboccipital retrosigmoid multidirectional approach with the aid of a rotatable head frame (periauricular three-quarter twist-rotation approach) in 20 cases of petroclival meningiomas. Patients were placed in the lateral decubitus (park-bench) position. The head is twisted, rotated, and positioned 30 degrees face down in the Sugita rotatable head frame. By rotating this head frame, a 30- to 60-degree face-down position can be obtained when the suboccipital retrosigmoid route is used. Alternatively, the straight lateral or slightly brow-up position is obtained when the subtemporal presigmoid route is used. This twist-rotation approach provides multiple trajectories through the petroclival region with minimal drilling of the petrous bone, fatigue of the surgeon, and retraction of the brain.
authors.affiliation: Department of Neurosurgery, National Medical Center of Yokohama, Yokohama, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Fujitsu
authors.forename: Yohichi
authors.initials: Y
authors.lastname: Kitsuta
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Takemoto
authors.forename: Shigeo
authors.initials: S
authors.lastname: Matsunaga
authors.forename: Kensuke
authors.initials: K
authors.lastname: Tateishi