Anterior Transpetrosal Approach

Abstract

The anterior transpetrosal approach is a skull base approach that is used for treating lesions in the cerebello- pontine angle or pre－pontine area. Trigeminal schwannomas and tentorial meningiomas extending to the Meckel’s cave are good indications for this surgical approach. This approach is also applicable for basilar trunk aneurysms and pontine cavernomas or gliomas. The weak points of this approach are a narrow and deep opera- tive field, the necessity of temporal lobe retraction, and a limited lesion site for manipulation（this surgical approach is not appropriate for lesions located around the lower cranial nerves） . Complications such as temporal lobe problems are concerns for surgeons during this procedure；therefore, lumbar drainage and／or controlling brain retractors are recommended for preventing these difficulties. Given that performance of the anterior transpetrosal approach requires skillful skull base techniques and mastery of methods to prevent complications, this surgical approach is not considered easy. Therefore, surgeons who perform this approach must have adequate knowledge of surgical anatomy so as not to be disoriented during surgery；they must also be aware of potential complications and how to avoid them.