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Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Extradural anterior transpetrosal approach: how I do it
Thibault Passeri1, Gabriel C Heemann2, Michelle Grouls2
1Department of Neurosurgery, Lariboisière Hospital, Assistance Publique des Hôpitaux de Paris (APHP), University of Paris Cité, 2 Rue Ambroise Paré, Paris, 75010, France. thibault.passeri@aphp.fr.
Background:
Petroclival and brainstem lesions remain challenging to access due to their deep-seated location and proximity to critical neurovascular structures.
Method:
We describe the step-by-step technique of the standard extradural anterior transpetrosal approach, and its extensions, illustrated through cadaveric and surgical illustrations. A surgical video demonstrates its application in a patient with a petroclival meningioma with posterolateral extension.
Conclusion:
The extradural anterior transpetrosal approach provides a direct « looking-down» trajectory to petroclival lesions with minimal brain retraction, making it a valuable route for safe and effective access to this complex anatomical region.
