Table of Contents

Retrosigmoid approach for cerebellopontine angle meningioma

Retrosigmoid approach for cerebellopontine angle meningioma is a safe surgical procedure.

The modern management of CPA meningiomas should achieve as complete a resection as possible within reasonable limits, considering that a small residual tumor can be controlled fairly easily with radiosurgery for a relatively long time 1).

Key points

Careful examination of preoperative studies is needed to identify anatomical peculiarities.

Patient positioning: the head must be gently flexed and its vertex gently tilted toward the floor.

Neurophysiologic monitoring and intraoperative navigation.

Craniectomy: partial exposure of the transverse and sigmoid sinuses.

Curvilinear dural incision reflected laterally to minimize the risk of sinus injury.

Opening the cerebellomedullary cistern for CSF drainage and cerebellar relaxation.

Videos

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Resection of a CP Angle Meningioma with Flexible CO2 Laser Fiber

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Fully endoscopic resection of cerebellopontine angle meningioma

see Fully endoscopic resection of cerebellopontine angle meningioma.

Postoperative facial nerve paralysis following a retrosigmoid approach for cerebellopontine angle meningioma surgery

Postoperative facial nerve paralysis following a retrosigmoid approach for cerebellopontine angle meningioma surgery

1)
Baroncini M, Thines L, Reyns N, Schapira S, Vincent C, Lejeune JP. Retrosigmoid approach for meningiomas of the cerebellopontine angle: results of surgery and place of additional treatments. Acta Neurochir (Wien). 2011 Oct;153(10):1931-40; discussion 1940. doi: 10.1007/s00701-011-1090-6. Epub 2011 Jul 29. PubMed PMID: 21800106.