Functional Surgery of Cerebellopontine Angle by Minimally Invasive Retrosigmoid Approach

by Jacques Magnan, Bhavin Parikh, Hidemi Miyazaki

The retrosigmoid approach is undoubtedly the most simple and direct access to the cerebellopontine angle and this approach is also the least well known amongst otologists. The purpose of this book is to discover, popularize and practice the retrosigmoid approach as it was originally conceived by otologists for otologists, but of course it can be used by all surgical specialties involved with pathologies of the cerebellopontine angle. The initial operations for cerebellopontine angle pathologies were long and laborious resulting in a narrow and deep operating field in which it was difficult to identify the elements of the acoustico-facial nerve bundle. Though the retrosigmoid approach by its topography and its objective was the daughter of the suboccipital approach, it is contrary to it in many aspects. The patient's position, the type of operating microscope, the instruments, the size of the craniotomy, the absence of mechanical retraction, whatever the postoperative consequences have no age limit. The minimally invasive retrosigmoid approach with neurosurgical armamentarium is quite difficult. Obviously the intrusion of ENT specialists in this deep and delicate space, the surgical elite's reserve, was subject to criticism not only by neurosurgeons but also by ENT specialists themselves.

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