Optimizing Workflow in Combined Petrosectomy Approaches: Surgical Technique and Case Series

Area of Science:

• Neurosurgery
• Otolaryngology
• Skull Base Surgery

Background:

• The combined petrosectomy is a standard skull base approach for petroclival region tumors.
• Traditional technique involves sequential neurosurgery and neuro-otology steps, leading to multiple team handoffs and potential workflow inefficiencies.

Purpose of the Study:

• To describe a modified technique for combined petrosectomy.
• To improve operating room workflow and reduce surgical team handoffs.

Main Methods:

• A resequenced surgical approach is presented, involving temporal bone drilling prior to temporosuboccipital craniotomy.
• Illustrations and surgical images detail the modified technique.
• A case series of 10 patients undergoing this modified procedure is included.

Main Results:

• Performing temporal bone drilling before craniotomy allows direct visualization of the dura and sinuses.
• This resequencing reduces the necessary transitions between otolaryngologist and neurosurgeon to one.
• The modified technique demonstrated feasibility, improved workflow, and reasonable operating times in 10 patients.

Conclusions:

• Combined petrosectomy can be effectively performed in a 2-step manner, contrasting the traditional 3-step approach.
• This modified technique offers similar outcomes and acceptable operative times while enhancing efficiency.