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Updated: Dec 11, 2025
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Sub-telo-velo-tonsillar approach to resect dorsal pons cavernoma through fourth ventricular floor opening: how I do
Sara Bonasia1, I De Trizio2, L Valci2
1Department of Neurosurgery, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Via Tesserete 46, 6900, Lugano, Switzerland. sara.bonasia@gmail.com.
Background:
Dorsal pons cavernoma can be approached through telo-velar approach instead of transvermian approach, with lower risk of neurological deficits since it uses natural clefts to reach the floor of the fourth ventricle.
Materials And Methods:
We present our surgical technique for telo-velar approach to address pathologies of the dorsal pons, assisted by neuronavigation and neuromonitoring. This surgical technique is illustrated by a surgical video of a dorsal pons cavernoma.
Conclusion:
Dorsal pons cavernomas can be reached through telo-velar approach after suboccipital midline craniotomy. The accurate patient positioning, cisternal dissection, and neuromonitoring use are mandatory to avoid neural injuries and identify the safe entry points into the brainstem.
