Minimally Invasive Endoscopic Retrosigmoid Approach to the Cerebellopontine Angle Using a Novel Surgical Instrument: A Cadaveric Study

Background: Minimally invasive surgery for the treatment of hallux valgus deformities has become increasingly popular. Knowledge of the location of the hallux metatarsophalangeal (MTP) proximal capsular origin on the metatarsal neck is essential for surgeons in planning and executing extracapsular corrective osteotomies. A cadaveric study was undertaken to further study this anatomic relationship. Methods: Ten nonpaired fresh-frozen frozen cadaveric specimens were used for this study. Careful dissection was performed, and the capsular origin of the hallux MTP joint was measured from the central portion of the metatarsal head in the medial, lateral, dorsal, plantarmedial, and plantarlateral dimensions. Results: The ten specimens had a mean age of 77 years, with 5 female and 5 male. The mean distances from the central hallux metatarsal head to the MTP capsular origin were 15.2 mm dorsally, 8.4 mm medially, 9.6 mm laterally, 19.3 mm plantarmedially, and 21.0 mm plantarlaterally. Conclusion: The MTP capsular origin at the hallux metatarsal varies at different anatomic positions. Knowledge of this capsular anatomy is critical for orthopedic surgeons when planning and performing minimally invasive distal metatarsal osteotomies for the correction of hallux valgus. Type of Study: Cadaveric Study.

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Translabyrinthine Approach for Acoustic Neuroma

Neurosurgery ◽

10.1227/01.neu.0000103668.26590.5a ◽

2004 ◽

Vol 54 (2) ◽

pp. 391-396 ◽

Cited By ~ 30

Author(s):

John Diaz Day ◽

Douglas A. Chen ◽

Moises Arriaga

Keyword(s):

Surgical Treatment ◽

Acoustic Neuroma ◽

Cerebellopontine Angle ◽

Hearing Preservation ◽

Retrosigmoid Approach ◽

The Past ◽

Translabyrinthine Approach ◽

Acoustic Neuromas

Abstract THE TRANSLABYRINTHINE APPROACH has been popularized during the past 30 years for the surgical treatment of acoustic neuromas. It serves as an alternative to the retrosigmoid approach in patients when hearing preservation is not a primary consideration. Patients with a tumor of any size may be treated by the translabyrinthine approach. The corridor of access to the cerebellopontine angle is shifted anteriorly in contrast to the retrosigmoid approach, resulting in minimized retraction of the cerebellum. Successful use of the approach relies on a number of technical nuances that are outlined in this article.

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Design of a novel surgical instrument for minimally invasive robotic surgery

2014 IEEE International Conference on Robotics and Biomimetics (ROBIO 2014) ◽

10.1109/robio.2014.7090334 ◽

2014 ◽

Cited By ~ 1

Author(s):

Bo Pan ◽

GuoJun Niu ◽

YiLi Fu ◽

DianGuo Xu ◽

Yongsheng Wang

Keyword(s):

Robotic Surgery ◽

Minimally Invasive ◽

Surgical Instrument ◽

Minimally Invasive Robotic Surgery

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Gross Total Resection of Large Cerebellopontine Angle Meningioma with a Supratentorial Extension via Retrosigmoid Approach with Suprameatal Drilling and Tentorial Sectioning

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0038-1669973 ◽

2018 ◽

Vol 79 (S 05) ◽

pp. S399-S401

Author(s):

Sima Sayyahmelli ◽

Adi Ahmetspahic ◽

Mustafa Baskaya

Keyword(s):

Surgical Resection ◽

Cerebellopontine Angle ◽

Surgical Techniques ◽

Retrosigmoid Approach ◽

World Health ◽

Gross Total Resection ◽

Total Resection ◽

Facial Numbness ◽

Magnetic Resonance Imaging Mri ◽

Health Organization

Meningiomas are the second most common neoplasm in the cerebellopontine angle (CPA), and are challenging lesions to treat surgically. With significant refinements in surgical techniques, operative morbidity, and mortality have been substantially reduced. Total or near-total surgical resection can be accomplished in the majority of cases via appropriately selected approaches, and with acceptable morbidity. In this video, we present a 51-year-old woman, who had a 2-year history of vertigo with symptoms that progressed over time. She presented with blurry vision, sensorineural hearing loss, tinnitus, left-sided facial numbness, and double vision. Magnetic resonance imaging (MRI) showed a left-sided homogeneously enhancing mass at CPA with a supratentorial extension. MRI appearance was consistent with a CPA meningioma with supratentorial extension. The patient underwent surgical resection via a retrosigmoid approach. Suprameatal drilling and tentorial sectioning were necessary to achieve gross total resection. The surgery and postoperative course were uneventful. The histopathology was a WHO (world health organization) grade I meningioma. MRI showed gross total resection of the tumor. After a 1.5-year follow-up, the patient is continuing to do well with no residual or recurrent disease. In this video, microsurgical techniques and important steps for the resection of this challenging meningioma of the cerebellopontine angle are demonstrated.The link to the video can be found at: https://youtu.be/CDto52GxrG4.

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