Surgical Anatomy of Posterior Fossa and Cerebellopontine Angle

Abstract

  In surgery for posterior fossa lesions, particularly cerebellopontine angle tumors, understanding the surgical anatomy is essential to obtain good surgical results. Surgery involving the subarcuate artery, vagal vein, and cochlear nerve in vestibular schwannoma without intending to preserve hearing can be justified depending on the surgical situation. The author selected one of three variations of mastoidectomy, depending on the disease and/or surgical goals, to save time and effort. Middle cranial fossa approaches, including the anterior transpetrosal and middle fossa approaches, which are not easy because of their tendency to be disorienting, and the necessity of hemostasis skills to manage bleeding from the middle cranial fossa base, were explained mainly in this paper. The authors also emphasized the ideal method for cutting the tentorium using a combined transpetrosal approach.