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Updated: May 7, 2026

Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
[Transcranial and Endonasal Skull Base Approaches for Cerebello-Pontine Angle Lesions]
Hiroki Morisako1, Atsufumi Nagahama, Takeo Goto
1Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine.
Abstract:
Cerebellopontine angle lesions should be reduced as much as possible while preserving the cranial nerve and brainstem functions. However, because the lesion is located deep and surrounded by various important structures, surgical procedure is difficult to perform, and a surgical strategy is important to avoid complications. Surgical outcomes have dramatically improved with the development of skull bases and microsurgical techniques. The main surgical approaches for cerebellopontine angle lesions include the anterior and posterior combined transpetrosal, anterior transpetrosal, lateral suboccipital, and endoscopic endonasal approaches. With the recent developments in endoscopic keyhole surgery, such as the endoscopic keyhole anterior transpetrosal approach, minimally invasive surgery for skull-base lesions has gradually begun. Here, we describe the preoperative checkpoints, selection of surgical approaches, and surgical techniques for the resection of cerebellopontine angle lesions.
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