Simple, Effective, Supine Positioning for the Retrosigmoid Approach

Abstract

Background:

The retrosigmoid approach is often used for posterior fossa pathology. Many variations of positioning exist. Here, we report a simple, safe, and quick positioning technique which maximizes patient safety, surgeon comfort, and intraoperative view.

Methods:

We reviewed the senior author’s prospective surgical database for retrosigmoid approaches to the posterior fossa and noted any complications or difficult exposures.

Results:

Over 970 retrosigmoid operations were performed over the course of 19 years. There were no positioning-related complications and no aborted surgeries due to inadequate exposure. No normal cerebellum was ever resected to increase exposure and no retractor was ever used in the posterior fossa.

Conclusions:

Supine positioning for the retrosigmoid approach is an excellent and safe positioning alternative.

Key words

retrosigmoid approach - microsurgery - cerebellopontine angle - skull base surgery

• References

• 1 Erdogan E, Civelek E, Onal MB et al. A new method of patient’s head positioning in suboccipital retrosigmoid approach. Neurol India 2009; 57: 777-779
• 2 Sampath P, Long DM. Acoustic neuromas. In: Winn RH. ed Youmans neurological surgery. 5^th edn. Saunders; Philadelphia: 2004. 1147-1168
• 3 Yamakami I, Uchino Y, Kobayashi E et al. Removal of large acoustic neurinomas (vestibular schwannomas) by the retrosigmoid approach with no mortality and minimal morbidity. J Neurol Neurosurg Psychiatry 2004; 75: 453-458