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首页> 外文期刊>Neurosurgery >Posterior transpetrosal approach: less is more.
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Posterior transpetrosal approach: less is more.

机译：后经股法：少即是多。

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OBJECTIVE: We describe our surgical posterior transpetrosal technique, particularly the transcrusal variant for lesions involving the upper and middle clivus, petroclival regions, and lesions that involve both the posterior and middle fossae. METHODS: An outline of the posterior transpetrosal technique involved, particularly the transcrusal variant, is described. Important superficial landmarks are identified, and a radical mastoidectomy is performed. The antrum is identified and entered, and, upon completion of the mastoidectomy and when Trautman's triangle is defined, the temporal and suboccipital craniotomies are completed. After bone flap elevation, dura opening, and incision along the middle fossa dura, the superior petrosal sinus is ligated and cut. Tentorium cut completion is at the incisura posterior to the trochlear nerve. Watertight dural closure and standard flap replacement and skin closure complete the technique. RESULTS: Clival exposure and the degree of temporal bone resection increase. Operative freedom also increases with increased temporal bone resection, especially when going from the retrolabyrinthine to transcrusal variants. Little is gained in terms of operative freedom and exposure of the clivus with resection of additional temporal bone beyond that of the transcrusal variant, and resection carries the cost of increasing morbidity, especially with respect to VIIth and VIIIth nerve function. CONCLUSION: The posterior transpetrosal approach and the transcrusal variant provide a lateral operative corridor to lesions of the upper and middle clivus. The transcrusal variant provides increased exposure and operative freedom similar to that provided by the transcochlear approach while minimizing cranial nerve morbidity.
机译：目的：我们描述了我们的外科后路经颅穿刺技术，特别是经皮颅变种术，用于涉及上，中锁骨，岩斜区和后，中窝的病变。方法：概述了所涉及的后经Petropalal技术，特别是经颅变异。确定重要的表面标志，并进行根治性乳突切除术。识别并输入胃腔，完成乳突切除术并定义Trautman三角形后，完成颞下枕和开颅手术。骨瓣抬高，硬脑膜打开并沿中窝硬脑膜切开切口后，结扎上睑窦。延髓切断完成在滑车神经后切牙处。防水的硬脑膜闭合和标准的皮瓣更换和皮肤闭合完善了该技术。结果：趾骨暴露和颞骨切除的程度增加。随着颞骨切除的增加，手术自由度也增加，尤其是当从迷路后迷路改为经颅变异时。在手术自由度和锁骨暴露方面，除经颅变异以外的其他颞骨切除术，收效甚微，而切除术则增加了发病率，特别是在第七和第八神经功能方面。结论：后经椎管入路和经颅变异体为上，中锁骨的病变提供了一个侧向手术通道。经颅变异提供了与经耳蜗入路相似的增加的暴露和手术自由，同时使颅神经发病率降至最低。

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