History, Variations, and Extensions of the Retrosigmoid Approach: Anatomical and Literature Review

Area of Science:

• Neurosurgery
• Surgical Anatomy

Background:

• The retrosigmoid approach is a primary surgical corridor for posterior fossa pathologies.
• Variations and "extended" terminology can cause confusion in surgical literature.

Purpose of the Study:

• To provide a comprehensive analysis of the retrosigmoid approach.
• To detail its history, anatomical landmarks, and potential extensions.
• To clarify terminology and applications in neurosurgery.

Main Methods:

• Review of anatomical landmarks and microsurgical techniques.
• Analysis of cerebrospinal fluid release and venous sinus localization.
• Description of Rhoton's rule of three for neurovascular relationships.

Main Results:

• The retrosigmoid approach evolved from the suboccipital approach.
• Anatomical landmarks and specific techniques are crucial for safe execution.
• Extensions include transmastoid, supracerebellar, far-lateral, jugular foramen, and perimeatal approaches.

Conclusions:

• The retrosigmoid approach is a versatile and essential technique in posterior fossa surgery.
• Its extensions allow for broad applicability to diverse pathologies.
• Adequate exposure can be achieved, potentially obviating the need for more complex surgical procedures.