J Neurol Surg B Skull Base 2023; 84(S 01): S1-S344
DOI: 10.1055/s-0043-1762088
Presentation Abstracts
Oral Abstracts

Accessing Premeatal Anterior Inferior Cerebellar Artery (AICA) Aneurysms through Infratentorial Presigmoid Retrolabyrinthine: A Cadaveric Study

Samer Hoz
1   University of Cincinnati, Cincinnati, Ohio, United States
,
Paolo Palmisciano
1   University of Cincinnati, Cincinnati, Ohio, United States
,
Edward J. Doyle III
1   University of Cincinnati, Cincinnati, Ohio, United States
,
Mark Johnson
1   University of Cincinnati, Cincinnati, Ohio, United States
,
Jonathan A. Forbes
1   University of Cincinnati, Cincinnati, Ohio, United States
,
Charles Prestigiacomo
1   University of Cincinnati, Cincinnati, Ohio, United States
,
Ravi Samy
1   University of Cincinnati, Cincinnati, Ohio, United States
,
Mario Zuccarello
1   University of Cincinnati, Cincinnati, Ohio, United States
,
Norberto Andaluz
1   University of Cincinnati, Cincinnati, Ohio, United States
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
 

Background: Aneurysms involving the proximal third of the anterior inferior cerebellar artery (AICA) may arise from the basilar artery (BA)-AICA origin or from the AICA segments proximal to the internal auditory canal (IAC). The surgical management of these aneurysms involves complex and invasive approaches and poses a major challenge.

Objective: To investigate the infratentorial presigmoid retrolabyrinthine approach as a surgical corridor for premeatal AICA aneurysms. The typical anatomic-radiological characteristics and variations were evaluated, and the related anatomical and radiological parameters were analyzed to predict surgical accessibility.

Methods: Five adult, injected, cadaveric heads were operated on both sides, performing a total of 10 surgical dissections. Eight morphometric parameters were measured, analyzed, and categorized into preprocedural, intraprocedural, and additional parameters.

Results: Preoperative anatomic-radiological parameters provide valuable information to select patients with favorable anatomy that may offer appropriate surgical accessibility to the premeatal AICA through a presigmoid retrolabyrinthine corridor. The position of the BA from the midline determines the degree of accessibility to the origin of AICA through the infratentorial presigmoid retrolabyrinthine approach. Comparisons with other available approaches were provided as well.[1] [2]

Conclusion: The premeatal AICA aneurysms can be accessed and clipped through the infratentorial presigmoid retrolabyrinthine corridor. Thus, avoiding the sacrifice of hearing and balance as compared with other available invasive alternative approaches. The selection of the appropriate patients should be based on the individualized preoperative radiological characteristics for both the vascular and bony anatomy.



Publikationsverlauf

Artikel online veröffentlicht:
01. Februar 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Bambakidis NC, Manjila S, Dashti S, Tarr R, Megerian CA. Management of anterior inferior cerebellar artery aneurysms: an illustrative case and review of literature. Neurosurg Focus 2009;26(5):E6
    PubMed
  • 2 Sekhar LN, Schessel DA, Bucur SD, Raso JL, Wright DC. Partial labyrinthectomy petrous apicectomy approach to neoplastic and vascular lesions of the petroclival area. Neurosurgery 1999;44(3):537–550, discussion 550–552
    PubMed