Lateral and Midline Suboccipital Approaches to CPA and Fourth Ventricle : Trans-cerebellomedullary Fissure Approach

Abstract

  The standard procedures of lateral and midline suboccipital approaches (SOAs) were summarized with special reference to head, neck, and body positioning ; scalp elevation ; muscle dissection ; craniotomy ; and cerebellomedullary fissure (CMF) dissection. In particular, complete dissection of the lateral CMF is extremely important for lateral SOA and medial CMF for midline SOA. Acknowledgment of these sequential surgical steps will help the surgeons to execute the lateral and midline SOA safely and steadily as well as avoid serious complications.