CC BY-NC-ND 4.0 · J Neurol Surg B 2018; 79(S 05): S397-S398
DOI: 10.1055/s-0038-1669982
Skull Base: Operative Videos
Georg Thieme Verlag KG Stuttgart · New York

Suboccipital Lateral Approach for Resection of Cerebellopontine Angle Meningioma: Operative Video and Technical Nuances

Mateus Reghin Neto
1  Department of Neurosurgery, Hospital Beneficência Portuguesa de São Paulo, Institute of Neurological Science of São Paulo, Bela Vista, São Paulo, Brasil
,
Heros Henrique Melo Almeida
1  Department of Neurosurgery, Hospital Beneficência Portuguesa de São Paulo, Institute of Neurological Science of São Paulo, Bela Vista, São Paulo, Brasil
,
João Paulo Almeida
2  Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
,
Ygor Peçanha Alexim
1  Department of Neurosurgery, Hospital Beneficência Portuguesa de São Paulo, Institute of Neurological Science of São Paulo, Bela Vista, São Paulo, Brasil
,
Matheus Merula de Almeida
1  Department of Neurosurgery, Hospital Beneficência Portuguesa de São Paulo, Institute of Neurological Science of São Paulo, Bela Vista, São Paulo, Brasil
,
Rodrigo Lima Tavares
1  Department of Neurosurgery, Hospital Beneficência Portuguesa de São Paulo, Institute of Neurological Science of São Paulo, Bela Vista, São Paulo, Brasil
,
Antonio Carlos Corrêa
1  Department of Neurosurgery, Hospital Beneficência Portuguesa de São Paulo, Institute of Neurological Science of São Paulo, Bela Vista, São Paulo, Brasil
,
Evandro de Oliveira
1  Department of Neurosurgery, Hospital Beneficência Portuguesa de São Paulo, Institute of Neurological Science of São Paulo, Bela Vista, São Paulo, Brasil
› Author Affiliations
Further Information

Address for correspondence

Heros Henrique Melo Almeida, MD
Department of Neurosurgery, Hospital Beneficência Portuguesa de São Paulo
Institute of Neurological Science of São Paulo, Praça Amadeu Amaral
27, 5 andar, Bela Vista, São Paulo, 01327-010
Brasil   

Publication History

01 June 2018

11 August 2018

Publication Date:
09 October 2018 (eFirst)

 

    Abstract

    We present the case of a 34-year-old woman, who presented to our department with a 4 months history of dizziness, hearing loss, and tinnitus on the right side. MRI (magnetic resonance imaging) scan demonstrated a large extra-axial lesion, suggestive of a meningioma, with dural attachments to the petrosal bone surface and tentorium, closely related with the trigeminal, abducens, facial, vestibulocochlear, and lower cranial nerves in the right side. Treatment options were discussed with the patient, and surgical resection was selected to remove the lesion, and decompress the cranial nerves and brainstem. The surgery was performed with a patient in a semi-seated position with head placed in a flexed, nonrotated position. A right lateral suboccipital approach was performed, exposing the right transverse and sigmoid sinuses. After dura opening, microsurgical dissection was used to open the cisterna magna, and obtain cerebellum relaxation. That was followed by identification of cranial nerves VII–XII and then identification of the tumor itself. Tumor debulking was then performed with use of suction and ultrasonic aspirator. After extensive resection, the tumor margins were dissected away from brainstem, cerebellum, and cranial nerves. Finally, the tumor attachment to the tentorium was coagulated and cut and the tumor was completely removed. Postoperative MRI confirmed complete resection of the tumor. The patient was discharged on the 1st week after surgery, with no additional postoperative deficits or complications.

    The link to the video can be found at: https://youtu.be/aZ3jhZTAeAA.


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    Zoom Image
    Fig. 1 MRI (magnetic resonance imaging) images–Preoperative and Postoperative.
    Zoom Image
    Fig. 2 Intraoperative image.

    www.thieme.com/skullbasevideos

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    Quality:

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    Conflict of Interest

    None.

    Address for correspondence

    Heros Henrique Melo Almeida, MD
    Department of Neurosurgery, Hospital Beneficência Portuguesa de São Paulo
    Institute of Neurological Science of São Paulo, Praça Amadeu Amaral
    27, 5 andar, Bela Vista, São Paulo, 01327-010
    Brasil   

      
    Zoom Image
    Fig. 1 MRI (magnetic resonance imaging) images–Preoperative and Postoperative.
    Zoom Image
    Fig. 2 Intraoperative image.