Retrosigmoid intradural inframeatal approach: indications and technique.
BACKGROUND
Surgery of lesions of the petrous apex involving the inframeatal/infralabyrinthine area is challenging and related to a high risk of complications. Various extensive skull-base approaches have been used.


OBJECTIVE
To present and evaluate our experience with a new hearing-preserving extension of the retrosigmoid approach to the inframeatal/infralabyrinthine area.


METHODS
The approach was used in 3 patients harboring lesions in the petrous apex with variable extension in the inframeatal/infralabyrinthine region. The surgical accessibility of the lesions offered by the approach, the completeness of tumor removal, and the outcome, in particular, the functional outcome and complication rate, were assessed.


RESULTS
The tumor could be resected from the target area in all cases. No approach-related complications occurred. Serviceable hearing and normal facial nerve functions were preserved in all cases.


CONCLUSIONS
Our initial experience with the retrosigmoid inframeatal approach showed that it provides sufficient access to the area and offers the possibility of complete tumor removal. It allows for hearing and facial nerve functional preservation. The approach is safe and related to a very low complication rate.
International Neuroscience Institute, Hanover, Germany.
Madjid
M
Samii
Hussam
H
Metwali
Amir
A
Samii
Venelin
V
Gerganov
D000328:Adult; D002813:Chondrosarcoma / Q000175:diagnosis / Q000601:surgery; D002817:Chordoma / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006099:Granuloma / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods; D010579:Petrous Bone / Q000473:pathology* / Q000601:surgery*; D012888:Skull Neoplasms / Q000175:diagnosis* / Q000601:surgery*