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1 results

  • Chapter 16 - Combined Petrosal Approach

  • from Section II - Open Combined Approaches
  • Edited by Vijay Agarwal
  • Book:
    Integrated Management of Complex Intracranial Lesions
    Published online:
    05 October 2021
    Print publication:
    21 October 2021, pp 164-181

  • Summary

    The combined petrosal approach (CTA) is one of the most complicated neurosurgical procedures. It is essential to learn and acquire the micro-anatomical key elements to complete a safe and less invasive CTA. The Fukushima lateral position can provide for an adequate surgical field and reduce the patient’s stress brought on by a long operative time. Three-layer scalp elevation including harvest of a vascularized flap is mandatory to carry out the closure. One should consider the bony landmarks to carry out the craniotomy safely and widely. The tentorial resection and dural incision are very important to secure the wide surgical field and to avoid complications. Closure with fat tissue and a vascularized flap is recommended to avoid postoperative CSF leak, deformity, and infection.