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IP Indian Journal of Anatomy and Surgery of Head, Neck and Brain


Anatomy of surgical presigmoid approach


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Author Details: JAUME Alejandra, ROMERO Mariana, DEVITA Andrea, MARTINEZ Fernando, SPAGNUOLO Edgardo

Volume : 3

Issue : 4

Online ISSN : 2581-5229

Print ISSN : 2581-5210

Article First Page : 110

Article End Page : 114


Abstract

Introduction: Presigmoid approach is defined as one that allows access to the middle and posterior fossa in front of the sigmoid sinus via transmastoid. The following is a descriptive work of the most important steps to consider during anatomical aspects of this approach.
Materials and Methods: Presigmoid approach was performed in 4 heads cadavers fixed in formalin solution cadavers, match with the help of electric drill and microscope magnification.
Results and Discussion: Starting 1cm skin incision above the zygoma and reaching mastoid 3cm below was performed. The temporalis and trapezius muscles forward and ECM back to expose the skull. The path of the transverse sinus topography by a line joining the inion supramastoid the crest. The dome of the sigmoid sinus level asterion and its drive shaft mastoid before emptying into the jugular gulf. The facial nerve was found on the tympanic and mastoid portion at the end of the mastoidectomy. After completing the craniotomy bone flap and lift the dural opening was performed with ligation of the superior petrosal sinus and tentorium section under a microscope to visualize the IV cranial nerve.
Conclusions: This approach allows access to complex regions in the skull base and the petroclival region. Anatomical knowledge is essential to minimize morbidity of the approach for injury to neurovascular structures.

Keywords: Approaches, Temporal bone, Transpetrosal, Presigmoid, Facial nerve surgery