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The modified transcochlear approach to the cerebellopontine angle
K L Horn1, H L Hankinson, M D Erasmus
1Presbyterian Ear Institute, Albuquerque, NM 87106-4924.
Summary
A modified transcochlear approach improves surgical access to the skull base, including the anterior petrous apex and cerebellopontine angle. This technique offers extensive lateral exposure for complex neurosurgical procedures.
Area of Science:
- Neurosurgery
- Otolaryngology
- Skull Base Surgery
Background:
- The transcochlear approach is utilized for accessing the petrous apex and posterior fossa.
- Limited exposure can be a challenge in certain skull base pathologies.
Purpose of the Study:
- To describe modifications of the transcochlear approach.
- To enhance surgical exposure of the anterior petrous apex, clivus, and cerebellopontine angle.
Main Methods:
- Resection of the external auditory canal, middle ear, glenoid fossa, and posterior zygomatic arch.
- A modified transcochlear approach was performed in 11 patients.
Main Results:
- The modified approach provided improved exposure of the petrous carotid artery, jugular bulb, and clivus.
- It offers the largest and most lateral access to the anterior cerebellopontine and prepontine regions.
Conclusions:
- The modified transcochlear approach significantly enhances surgical visualization.
- This technique is beneficial for complex anterior skull base and cerebellopontine angle pathologies.