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Updated: Aug 18, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
[The anterosigmoidal approach. A function-preserving surgical method for petroclival tumors]
J Schipper1, G J Ridder, W Maier
1Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde und Poliklinik, Universitätsklinikum Freiburg. schipper@hno.ukl.uni-freiburg.de
Background And Objective:
The antero- or persigmoid approach preserves all functional structures of the petrous bone and, therefore, is an alternative to the classic laterobasal approaches for exploring the petroclival region. As high morbidity is assumed and it is a time consuming procedure, this approach is not well known.
Methods And Patients:
Initially, a cadaver study using computer assisted surgery was used to determine the surgical workflow before we optimized our surgical procedures.
Results:
In a series of 7 patients with benign tumors growing from the petrous apex to the petroclival region, we were able to resect all tumors completely via the anterosigmoidal surgical corridor using computer assisted surgery.
Conclusions:
The navigation-guided anterosigmoidal approach is an excellent method, allowing a good overview of the petroclival region. In patients suffering from complex petroclival tumors, it offers a real chance to achieve complete microsurgical tumor resection without functional defects by an interdisciplinary neuro-oto-surgical session.
