[The anterosigmoidal approach. A function-preserving surgical method for petroclival tumors]

Area of Science:

• Neurosurgery
• Otolaryngology
• Skull Base Surgery

Background:

• The anterosigmoidal approach is an alternative to classic laterobasal approaches for petroclival region exploration.
• It preserves functional structures of the petrous bone.
• This approach is less known due to perceived high morbidity and time consumption.

Purpose of the Study:

• To evaluate the efficacy and safety of the navigation-guided anterosigmoidal approach for petroclival tumor resection.
• To determine if this approach allows for complete tumor removal without functional deficits.

Main Methods:

• Initial cadaver study utilizing computer-assisted surgery to define the surgical workflow.
• Optimization of surgical procedures based on cadaveric findings.
• Application of the optimized approach in a series of 7 patients with benign petroclival tumors.

Main Results:

• Complete resection of benign tumors in the petrous apex to petroclival region was achieved in all 7 patients.
• The anterosigmoidal surgical corridor, combined with computer assistance, facilitated successful tumor removal.
• The approach provided a good overview of the petroclival region.

Conclusions:

• The navigation-guided anterosigmoidal approach is an excellent method for accessing the petroclival region.
• It offers a viable option for complete microsurgical resection of complex petroclival tumors.
• This technique, performed in an interdisciplinary neuro-oto-surgical setting, can achieve tumor resection without functional defects.