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J Neurol Surg B Skull Base 2021; 82(05): 562-566
DOI: 10.1055/s-0040-1715561
Original Article

Far Lateral Craniotomy Closure Technique for Preservation of Suboccipital Musculature

Muhammad Salman Ali   *
1   Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, United States
,
Stephen T. Magill    *
1   Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, United States
,
Michael W. McDermott
1   Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, United States
› Author Affiliations Funding None.
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Abstract

The far lateral approach is used for accessing pathology at the craniovertebral junction but can be complicated by postoperative suboccipital muscle atrophy. In addition to significant cosmetic deformity, this atrophy can lead to head and neck pain and potentially could contribute to cranio-cervical instability. To address this issue, the senior author began using a single myocutaneous flap without a muscle cuff and securing it directly to the bone using predrilled holes in the bone that resemble a chevron. The method is described and illustrated with an example case. Results from seven consecutive cases are reported since the technique was adopted. Muscle atrophy was measured by calculating area at the level of the occipital condyle and compared with the contralateral side. No significant differences were noted. In conclusion, we have found this to be an excellent closure technique and wanted to present our initial results for consideration by other skull base surgeons.

Keywords

far lateral - transcondylar - muscle atrophy - modified far lateral - extreme lateral - technique

* Authors contributed equally to this study.




Publication History

Received: 07 April 2020

Accepted: 22 June 2020

Article published online:
20 August 2020

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