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Lateral approaches to the median skull base through the petrous bone: the system of the modified transcochlear approach

Published online by Cambridge University Press:  29 June 2007

Mario Sanna*
Affiliation:
Gruppo Otologico, Piacenza, Italy
Antonio Mazzoni
Affiliation:
Department of ENT, Ospedale Riuniti, Bergamo, Italy
Essam A. Saleh
Affiliation:
Department of Otolaryngology, Faculty of Medicine, Alexandria University, Egypt. (Dr Saleh is at present Clinical Research Fellow at the Gruppo Otologico, Piacenza, Italy.)
Abdel K. Taibah
Affiliation:
Gruppo Otologico, Piacenza, Italy
Alessandra Russo
Affiliation:
Gruppo Otologico, Piacenza, Italy
*
Dr Mario Sanna, Gruppo Otologico, Via Emmanueli, 42, 29100 Piacenza, Italy. Fax: 39-523-453708

Abstract

Twenty-three patients with intradural lesions of the petroclival region and prepontine cistern were managed in our centres by the modified transcochlear approach. Total tumour removal was accomplished in 17 patients, while a second stage was planned for the remaining six patients. Two cases died in the immediate postoperative period. All the remaining cases showed a good outcome and returned to work. The basic approach type A is further classified according to its anterior, superior and inferior extension into types B, C and D respectively. The surgical procedure, classification, illustrative case reports and patients' summaries are presented.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1994

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Footnotes

This work has been supplied by a grant from the Associazione Italiana Neurotologica (A.I.N.OT).

References

Al-Mefty, O., Fox, J. L., Smith, R. R. (1988) Petrosal approach for petroclival meningiomas. Neurosurgery, 22: 510517.CrossRefGoogle ScholarPubMed
Biggs, M. T., Fagan, P. A., Sheehy, J. P. R., Bentivoglio, P. J., Doust, B. D., Tonkin, J. (1991) Meningioma of the posterior skull base. Skull Base Surgery 1: 4350.CrossRefGoogle ScholarPubMed
Canalis, R. F., Black, K., Martin, N., Becker, D. (1991) Extended retrolabyrinthine transtentorial approach to petroclival lesions. Laryngoscope 101: 613.CrossRefGoogle ScholarPubMed
Daspit, C. P., Spetzler, R. F., Pappas, C. T. E. (1991) Combined approach for lesions involving the cerebellopontine angle and skull base: experience with 20 cases – preliminary report. Otolaryngology – Head and Neck Surgery 105: 788796.CrossRefGoogle ScholarPubMed
Fisch, U. (1978) Infratemporal fossa approach to tumours of the temporal bone and base of the skull. Journal of Laryngology and Otology 92: 949967.CrossRefGoogle ScholarPubMed
Hakuba, A., Nishimura, S., Tanaka, K., Kishi, H., Nakamura, T. (1977) Clivus meningioma: six cases of total removal. Neurologica Medica Chirurgica (Tokyo) 17: 6377.CrossRefGoogle ScholarPubMed
Hitselberger, W. E., Horn, K. L., Hankinson, H., Brackmann, D. E., House, W. F. (1993) The middle fossa transpetrous approach for petroclival meningiomas. Skull Base Surgery 3: 130135.CrossRefGoogle ScholarPubMed
Horn, K. L., Hankinson, H. L., Erasmus, M. D., Beauparalant, P. A. (1991) The modified transcochlear approach to the cerebellopontine angle. Otolaryngology – Head and Neck Surgery 104: 3741.CrossRefGoogle ScholarPubMed
House, J. W., Brackmann, D. E. (1985) Facial nerve grading system. Otolaryngology – Head and Neck Surgery 93: 146147.CrossRefGoogle ScholarPubMed
House, W. F., Hitselberger, W. E. (1976) The transcochlear approach to the skull base. Archives of Otolaryngology 102: 334342.CrossRefGoogle ScholarPubMed
House, W. F., Hitselberger, W. E., Horn, K. L. (1986) The middle fossa transpetrous approach to the anterior-superior cerebellopontine angle. American Journal of Otology 7: 14.Google Scholar
Jenkins, H. A., Fisch, U. (1980) The transotic approach to resection of difficult acoustic tumors of the cerebellopontine angle. American Journal of Otology 2: 7076.Google ScholarPubMed
Krespi, Y. P., Levine, T. M., Oppenheimer, B. (1986) Skull base chordomas. Otolaryngologic Clinics of North America 19: 797804.CrossRefGoogle ScholarPubMed
Mazzoni, A., Sanna, M. (1992) The petro-occipital trans-sigmoid approach to the postero-lateral skull base. Results and indications. Presented at the 3rd Annual Meeting of the North American Skull Base Society,Acapulco,Mexico,February 15–20.Google Scholar
Mirimanoff, R. O., Dosoretz, D. E., Linggood, R. M., Ojemann, R., Martuza, R. (1985) Meningioma: analysis of recurrence and progression following neurosurgical resection. Journal of Neurosurgery 22: 510517.Google Scholar
Pellet, w., Cannoni, M., Pech, A. (1987) The widened transcochlear approach to jugular foramen tumours. Journal of Neurosurgery 69: 887894.CrossRefGoogle Scholar
Saleh, E., Aristegui, M., Taibah, A., Mazzoni, A., Sanna, M. (1994) Management of the high jugular bulb in the translabyrinthine approach. Otolaryngology – Head and Neck Surgery 110: 397399.CrossRefGoogle ScholarPubMed
Sanna, M., Mazzoni, A. (1992) The modified transcochlear approach to the tumours of the petroclival area and prepontine cistern. Presented at the 3rd Annual Meeting of the North American Skull Base Society.February 15–20,Acapulco,Mexico.Google Scholar
Samii, M., Ammirati, M. (1988) The combined supra-infratentroial pre-sigmoid sinus avenue to the petroclival region. Surgical technique and clinical applications. Acta Neurochirurgica 95: 612.CrossRefGoogle Scholar
Sekhar, L. N., Estonillo, R. (1986) Transtemporal approach to the skull base: an anatomical study. Neurosurgery 19: 799808.CrossRefGoogle Scholar
Thedinger, B. A., Glasscock, M. E., Cueva, R. A. (1992) Transcochlear transtentorial approach for removal of large cerebellopontine angle meningiomas. American Journal of Otology 13: 408415.Google ScholarPubMed