J Neurol Surg B Skull Base
DOI: 10.1055/s-0041-1740971
Original Article

Modified Skin Incision and Location of Burr-Hole Surgery via a Retrosigmoid Approach: An Anatomical Study

Lean Sun
1   Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Wuhu, China
,
Min Qi
1   Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Wuhu, China
,
Xuefei Shao
1   Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Wuhu, China
,
Sansong Chen
1   Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Wuhu, China
,
Xinyun Fang
1   Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Wuhu, China
,
Wei Zhou
1   Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Wuhu, China
,
Wei Zhou
1   Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Wuhu, China
,
Hao Chen
1   Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Wuhu, China
,
Guoyuan He
1   Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Wuhu, China
,
Xiran Fan
1   Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Wuhu, China
,
Yongkang Sun
1   Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Wuhu, China
,
1   Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Wuhu, China
,
Xiaochun Jiang
1   Department of Neurosurgery, Yijishan Hospital, Wannan Medical College, Wuhu, China
› Author Affiliations

Abstract

Objective This study aims to reduce the tissue damage during craniotomy with retrosigmoid approach. A modified sickle-shaped skin incision was developed, and a new burr-hole positioning method was proposed.

Methods Five adult cadaveric heads (10 sides) were used in this study. The sickle-shaped skin incision was performed during craniotomy. The nerves, blood vessels, and muscles were observed and measured under a microscope. Additionally, 62 dry adult skull specimens (left sided, n = 35; right sided, n = 27) were used to measure the distance between the most commonly used locating point (asterion [Ast] point) and the posteroinferior point of the transverse sigmoid sinus junction (PSTS) (Ast-PSTS), as well as the distance between the new locating O point and the PSTS (O-PSTS). Then, the reliability of the new locating O point was validated on the same five adult cadaveric heads (10 sides) used for the sickle-shaped skin incision.

Results The sickle-shaped skin incision reduced the damage to the occipital nerves, blood vessels, and muscles during the surgery via a retrosigmoid approach. The dispersion and variability of O-PSTS were smaller than those of Ast-PSTS.

Conclusion The sickle-shaped skin incision of the retrosigmoid approach can reduce the tissue damage and can completely expose the structures in the cerebellopontine angle. The modified O point is a more reliable locating point for a burr-hole surgery than the Ast point.

Ethics Approval

The study was approved by the Institutional Ethics Committee and performed in accordance with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.




Publication History

Received: 22 October 2020

Accepted: 12 November 2021

Publication Date:
16 January 2022 (online)

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