A Comparison of Cerebellar Retraction Pressures in Posterior Fossa Surgery: Extended Retrosigmoid Versus Traditional Retrosigmoid Approach

Brandon D. Liebelt, Meng Huang, Gavin W. Britz

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background: The retrosigmoid approach is broadly applicable to many posterior fossa procedures. However, cerebellar retraction is often necessary for lesions in the cerebellopontine angle, which can lead to complications. An extended retrosigmoid approach skeletonizes the sigmoid sinus and allows a wider corridor with less retraction. This study investigated the differences in retraction pressure between the retrosigmoid and extended retrosigmoid approach in a cadaveric model. Methods: Anatomic dissection of 2 cadaveric heads was performed for comparison of surgical approaches. Bilateral measurements were obtained on each head, providing 4 sets of data. Retrosigmoid craniotomy was first performed with recording of retraction pressure necessary for 1.5-cm exposure. The exposure was then expanded to an extended retrosigmoid approach, and retraction pressures were recorded. Results: Mean retraction pressure in cadaver 1 for retrosigmoid and extended retrosigmoid approaches was 20.25 ± 5.9 mm Hg and 10.25 ± 3.8 mm Hg, respectively; in cadaver 2, values were 11.75 ± 3.1 mm Hg and 4.75 ± 1.8 mm Hg, respectively. This corresponded to a mean relative reduction in retraction pressure of 49.4% in cadaver 1 and 59.6% in cadaver 2 by using the extended retrosigmoid approach. Retraction pressures were also significantly less (P < 0.05) for the extended retrosigmoid group when comparing all surgical approaches (N = 4). Conclusions: The extended retrosigmoid approach gains better visualization with reduced brain retraction. In our study, cerebellar retraction pressures were greatly reduced when using the extended retrosigmoid approach in a cadaveric model.

Original languageEnglish (US)
Pages (from-to)e88-e92
JournalWorld neurosurgery
Volume113
DOIs
StatePublished - May 2018

Keywords

  • Extended retrosigmoid
  • Retraction pressure
  • Retrosigmoid
  • Skull base

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Fingerprint Dive into the research topics of 'A Comparison of Cerebellar Retraction Pressures in Posterior Fossa Surgery: Extended Retrosigmoid Versus Traditional Retrosigmoid Approach'. Together they form a unique fingerprint.

Cite this