Türk Nöroşirürji Dergisi 2001 , Vol 11 , Num 3
PARTIAL LABYRINTHECTOMY PETROUS APICECTOMY TRANSPETROSAL APPROACH: AN ANATOMIC STUDY
Emel AVCI
The Harvey H. Ammerman Neurosurgical Laboratory Department of Neurosurgery George Washington University 2150 Pennsylvania Avenue NW Washington USA Within the subspecialty of Skull Base surgery, the management of lesions in the petroclival region is associated with the highest incidence of mortality and morbidity. Several transpetrosal approaches have been described to access this region; the partial labyrinthectomy petrous apicectomy (PLPA) is one such approach. By removing the superior and posterior semicircular canals, and resecting the petrous apex, this approach gives the surgeon the opportunity to treat vascular and neoplastic lesions in the upper 2/3 of the clivus with less brain retraction while simultaneously preserving hearing. In this study, the PLPA approach has been used in 10 cadavers to illustrate important surgical technical points and to analyze the benefits of using the endoscope along with the microscope when using this approach to the petroclival region. The use of various degree endoscopes as an adjunct to the microscope in this approach improves visualization of the jugular foramen, hypoglossal canal and the neurovascular structures of the contralateral side. Anahtar Kelimeler : Endoscope, partial labyrinthectomy, petroclival region, transpetrosal approach, surgical technique