Surgical treatment of acoustic neuromas necessitates opening a corridor to the cerebellopontine angle and middle ear. Suboccipital and retrosigmoid craniotomies spare the petrous bone, and these approaches afford sufficient access for the safe and adequate resection of many tumors. These approaches may preserve hearing. Because of their size and extension into the middle ear, however, some acoustic neuromas require more extensive surgical exposure. In these cases, a petrosectomy can be performed. To minimize complications related to a complete petrosectomy, other approaches that remove variable amounts of the petrous bone have been developed. In contrast to suboccipital and retrosigmoid craniotomies, these approaches provide surgeons a wider working angle and more direct exposure of portions of tumor extending into the middle ear. Typically, these advantages are gained at the expense of hearing, however. This article reviews the surgical approaches that use a posterior petrosectomy to access acoustic neuromas: the retrolabyrinthine, translabyrinthine, and transcochlear approaches. Copyright Â© 2001 W.B. Saunders Company.
Operative Techniques in Neurosurgery
Digital Object Identifier (DOI)
Zubay, Geoffrey; Porter, Randall W.; and Spetzler, Robert F., "Transpetrosal Approaches" (2001). Neurosurgery. 484.