Transpetrosal approach: surgical anatomy and technique

Transpetrosal operations have been shown to offer distinct advantages over traditional operations in approaching lesions of the petroclival area. Confusion about these approaches exists due to the variety of names given to these procedures and the lack of detailed descriptions needed to perform them. After extensive review of the literature, we have determined that all transpetrosal techniques fall into one of two categories: anterior petrosectomy or posterior petrosectomy. Combining one of these procedures with existing conventional procedures accurately describes all existing transpetrosal operations and eliminates confusion over nomenclature. In addition, through a series of cadaveric dissections and operative experience, we have detailed each of these procedures as a series of steps that will enable the surgeon to understand the unfamiliar anatomy of the temporal bone and to perform these transpetrosal techniques.