Cerebello-pontine Angle Tumors

Whitfield, Peter; Hardy, David G.

doi:10.1007/978-1-84628-294-2_14

Cited by 2 publications

(5 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Extensive temporal lobe retraction can result in postoperative seizures, aphasia, venous complications, or other focal neurological deficits. 2,11,30 The stretch of the inferior anastomotic vein (vein of Labbé) and of other temporal lobe basal veins are potentially serious complications that can lead to massive infarction and even death in some cases. 5,14,19,31 Keyhole and endoscopic subtemporal ap- proaches, as well as zygomatic arch osteotomy, have been proposed to reduce these complications.…”

Section: Discussionmentioning

confidence: 99%

Is less always better? Keyhole and standard subtemporal approaches: evaluation of temporal lobe retraction and surgical volume with and without zygomatic osteotomy in a cadaveric model

Ercan

Scerrati

et al. 2017

Journal of Neurosurgery

View full text Add to dashboard Cite

OBJECTIVE The subtemporal approach is one of the surgical routes used to reach the interpeduncular fossa. Keyhole subtemporal approaches and zygomatic arch osteotomy have been proposed in an effort to decrease the amount of temporal lobe retraction. However, the effects of these modified subtemporal approaches on temporal lobe retraction have never been objectively validated. METHODS A keyhole and a classic subtemporal craniotomy were executed in 4 fresh-frozen silicone-injected cadaver heads. The target was defined as the area bordered by the superior cerebellar artery, the anterior clinoid process, supraclinoid internal carotid artery, and the posterior cerebral artery. Once the target was fully visualized, the authors evaluated the amount of temporal lobe retraction by measuring the distance between the base of the middle fossa and the temporal lobe. In addition, the volume of the surgical and anatomical corridors was assessed as well as the surgical maneuverability using navigation and 3D moldings. The same evaluation was conducted after a zygomatic osteotomy was added to the two approaches. RESULTS Temporal lobe retraction was the same in the two approaches evaluated while the surgical corridor and the maneuverability were all greater in the classic subtemporal approach. CONCLUSIONS The zygomatic arch osteotomy facilitates the maneuverability and the surgical volume in both approaches, but the temporal lobe retraction benefit is confined to the lateral part of the middle fossa skull base and does not result in the retraction necessary to expose the selected target.

show abstract

Section: Discussionmentioning

confidence: 99%

Is less always better? Keyhole and standard subtemporal approaches: evaluation of temporal lobe retraction and surgical volume with and without zygomatic osteotomy in a cadaveric model

Ercan

Scerrati

et al. 2017

Journal of Neurosurgery

View full text Add to dashboard Cite

show abstract

“…The main drawback of the classic MFA is the risk of retraction injury to the temporal lobe as traditionally deep midline dissection of the skull base has necessitated a certain degree of temporal retraction to gain sufficient surgical exposure (3,11,19,31). Extensive temporal retraction can result in postoperative seizures, aphasia, or other focal neurologic deficits, and/or venous complications (2,3,7,9,15,31).…”

Section: Discussionmentioning

confidence: 99%

“…Extensive temporal retraction can result in postoperative seizures, aphasia, or other focal neurologic deficits, and/or venous complications (2,3,7,9,15,31). Compromise of the inferior anastomotic vein (vein of Labbé) is a potentially serious complication that could lead to massive infarction and death in cases with a small or obstructed superior anastomotic vein (vein of Trolard) wherein the vein of Labbé may be the only site of venous drainage for the entire hemisphere (7,9,15).…”

Section: Discussionmentioning

confidence: 99%

“…T he middle fossa approach (MFA), first proposed in the earlier 20th century for the treatment of otosclerosis and later for the resection of acoustic neuromas by House and Shelton, is indicated for the management of small tumors ( 1.5 cm) of the internal auditory canal (IAC) with an extension of less than 1 cm into the cerebellopontine angle (CPA) in patients with no preoperative auditory deficits (2,16,17,31). The MFA provides exposure of the entire length of the IAC and the facial (cranial nerve [CN] VII) and vestibular (CN VIII) nerves from the inner ear to the pons (2,16,17).…”

Section: Introductionmentioning

confidence: 99%

“…However, the complex microsurgical anatomy of the petrous bone and the neurovascular structures it encases, and the difficulty of identifying landmarks on the petrous ridge, make this a technically challenging approach (Figure 1). The main drawback of the classic MFA is the risk of retraction injury to the temporal lobe (19,31). Extensive temporal retraction can result in postoperative seizures, aphasia, or other focal neurologic deficits, and/ or venous complications from the compromise of the inferior anastomotic cerebral vein (vein of Labbé) (2,3,7,9,15).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations