Application of Keyholes to Large and Complex Posterior Fossa Pathology

Large and complex posterior fossa pathology can pose significant challenges for the operating neurosurgeon with high risk for potential complications. This series will explore the use of the mini retrosigmoid approach in this setting. Emphasis will be place on operative nuances and endoscopic utility to assist with maximal tumor resection, while protecting critical structures. A total of 41 mini retrosigmoid approaches were performed. This series includes 12 vestibular schwannomas, 3 trigeminal schwannomas, 21 meningiomas—including five petroclival meningiomas and five epidermoids. Gross total resection was achieved in 36 of 41 patients with near-total resection achieved in 3 patients and subtotal resection in 2 patients. Two CSF leak were encountered in the study. Six patients encountered cranial nerve fall-out postoperatively, with 3 patients experiencing signigicant recovery in the follow-up period. The author will share their experience and nuances related to tackling large and complex pathology in this region. Surgical videos will be presented.

Fig. 1

Fig. 2

Fig. 3

Fig. 4

 

MissingLinkText

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
07 February 2025