Antunes, Apio Cláudio Martins

Falcetta, Frederico Soares

Franciscato, André Ceruti

Isolan, Gustavo Rassier

Modrovski, Rafael

Santos, Omar Antônio dos

Stefani, Marco Antonio

Ávila, Thiago Torres de

Portuguese

Lume 5.8

204 Revista HCPA 2007; 27 (Supl.1) THE PARADIGM OF SKULL BASE APPROACHES TO TREAT CENTRAL NERVOUS SYSTEM TUMORS: PART I: THE PETROSAL APPROACH GUSTAVO RASSIER ISOLAN M.D., PHD; MARCO ANTÔNIO STEFANI M.D., PHD., ÁPIO CLÁUDIO MARTINS ANTUNES M.D., PHD; FREDERICO FALCETTA M.S.; OMAR ANTÔNIO DOS SANTOS MD; RAFAEL MODKOVSKI MD; ANDRÉ CERUTTI FRANCISCATO MD; THIAGO TORRES DE ÁVILA MD Introduction: The petrosal approach provides excellent access to the petroclival region, the basilar trunk and apex, the anteromedial midbrain and the pons. To acess these regions the petrosal approach offers a number of advantages: (1) the surgeon’s operative distance to these regions is shorter than in retrosigmoid approaches. (2) There is minimal retraction of the cerebellum and temporal lobe. (3) The neural structures (seventh and eight nerve) are preserved. (4) The otologic structures (cochlea, labyrinth, semicircular canals ) are preserved. (5) Finally, the major venous sinuses (transverse and sigmoid), along with the vein of Labbe and other temporal and basal veins, are preserved. Material and Methods: The petrosal approach was performed in ten cadaveric specimens at the Microsurgical Laboratory (University of Arkansas for Medical Sciences). Two cases operated at the Hospital de Clínicas de Porto Alegre are presented to illustrate this approach. These cases were a huge tentorial and petrosal meningeomas, respectively. Results: the surgical steps patient position, craniotomy flap, cutting the tentorium and closure are described, as well as the microsurgical anatomy. The tumor total resection was achieved in both patients without postoperative deficits. Conclusion: The petrosal approach is intended to gain direct access to the petroclival and perimesencephalic regions while avoiding some of the complications associated with other approaches to this area.    

The paradigm of skull base approaches to treat central nervous system tumors : part I: the petrosal approach

https://lume.ufrgs.br/bitstream/10183/127522/1/000699452.pdf

The paradigm of skull base approaches to treat central nervous system tumors : part I: the petrosal approach

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