Skull Base 2011; 21(2): 123-128
DOI: 10.1055/s-0030-1265826
ORIGINAL ARTICLE

© Thieme Medical Publishers

Dural Opening/Removal for Combined Petrosal Approach: Technical Note

Shunsuke Terasaka1 , Katsuyuki Asaoka1 , 2 , Hiroyuki Kobayashi1 , Taku Sugiyama1 , Shigeru Yamaguchi1
  • 1Department of Neurosurgery, Hokkaido University, Graduate School of Medicine, Sapporo, Japan
  • 2Department of Neurosurgery, Teine Keijinkai Medical Center, Sapporo, Japan
Further Information

Publication History

Publication Date:
08 September 2010 (online)

ABSTRACT

Detailed descriptions of stepwise dural opening/removal for combined petrosal approach are presented. Following maximum bone work, the first dural incision was made along the undersurface of the temporal lobe parallel to the superior petrosal sinus. Posterior extension of the dural incision was made in a curved fashion, keeping away from the transverse-sigmoid junction and taking care to preserve the vein of Labbé. A second incision was made perpendicular to the first incision. After sectioning the superior petrosal sinus around the porus trigeminus, the incision was extended toward the posterior fossa dura in the middle fossa region. The tentorium was incised toward the incisura at a point just posterior to the entrance of the trochlear nerve. A third incision was made longitudinally between the superior petrosal sinus and the jugular bulb. A final incision was initiated perpendicular to the third incision in the presigmoid region and extended parallel to the superior petrosal sinus connecting the second incision. The dural complex consisting of the temporal lobe dura, the posterior fossa dura, and the freed tentorium could then be removed. In addition to extensive bone resection, our strategic cranial base dural opening/removal can yield true advantages for the combined petrosal approach.

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Hiroyuki KobayashiM.D. 

Department of Neurosurgery, Graduate School of Medicine, Hokkaido University

North 15 West 7, Kita-ku, Sapporo 060-8638, Japan

Email: hiro-ko@med.hokudai.ac.jp

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