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Chapter 16 - Combined Petrosal Approach

from Section II - Open Combined Approaches

Published online by Cambridge University Press:  05 October 2021

By
Hikari Sato ,
Takanori Fukushima  and
Allan Friedman
Edited by
Vijay Agarwal
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Summary

The combined petrosal approach (CTA) is one of the most complicated neurosurgical procedures. It is essential to learn and acquire the micro-anatomical key elements to complete a safe and less invasive CTA. The Fukushima lateral position can provide for an adequate surgical field and reduce the patient’s stress brought on by a long operative time. Three-layer scalp elevation including harvest of a vascularized flap is mandatory to carry out the closure. One should consider the bony landmarks to carry out the craniotomy safely and widely. The tentorial resection and dural incision are very important to secure the wide surgical field and to avoid complications. Closure with fat tissue and a vascularized flap is recommended to avoid postoperative CSF leak, deformity, and infection.

Keywords

vascularized flapbony trianglestentorial resection
Type
Chapter
Information
Integrated Management of Complex Intracranial Lesions
Open, Endoscopic, and Keyhole Techniques
 , pp. 164 - 181
Publisher: Cambridge University Press
Print publication year: 2021

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References

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