Retrosigmoid intradural inframeatal petrosectomy
see Retrosigmoid intradural inframeatal approach.
Lesions infiltrating the petrous temporal bone are some of the most complex to treat surgically. Many approaches have been developed in order to address these lesions, including endoscopic endonasal, anterior petrosectomy, posterior petrosectomy, and retrosigmoid.
The retrosigmoid intradural inframeatal petrosectomy may afford satisfactory exposure with limited drilling and minimal disruption of perilesional anatomical structures. It can provide excellent surgical results, especially for soft tumors, while minimizing surgical morbidity 1).
Menegatti M, Travaglini F, Gelmi CAE. Letter: “How I do it: retrosigmoid intradural inframeatal petrosectomy”. Acta Neurochir (Wien). 2021 Mar 9. doi: 10.1007/s00701-021-04799-y. Epub ahead of print. PMID: 33687561.
Surgical removal of giant vestibular schwannomas with severe petrous bone involvement remains challenging due to the high risk of complications. The retrosigmoid intradural suprameatal-inframeatal approach (RISIA) allows for safe exposure extending from Meckel's cave to the petrous internal carotid artery (ICA).
Sato et al. demonstrated the usefulness of this approach in patients with recurrent giant vestibular schwannoma 2).