Minimizing skull defects in retrosigmoid approach: precision mapping of the sigmoid sinus with mastoid emissary vein canal
Objective. The retrosigmoid approach is a commonly used cranial approach to the cerebellopontine angle lesions, vascular and nerve pathologies. This study aims to develop a practical technique for intraoperative mapping of the sigmoid sinus using the topography of the mastoid emissary vei...
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| Format: | Article |
| Language: | English |
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Romodanov Neurosurgery Institute
2024-12-01
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| Series: | Ukrainian Neurosurgical Journal |
| Online Access: | https://theunj.org/article/view/313077 |
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| author | Artem V. Rozumenko Mykola V. Yehorov Vasyl V. Shust Dmytro M. Tsiurupa Anton M. Dubrovka Petro M. Onishchenko Volodymyr O. Fedirko |
| author_facet | Artem V. Rozumenko Mykola V. Yehorov Vasyl V. Shust Dmytro M. Tsiurupa Anton M. Dubrovka Petro M. Onishchenko Volodymyr O. Fedirko |
| author_sort | Artem V. Rozumenko |
| collection | DOAJ |
| description |
Objective. The retrosigmoid approach is a commonly used cranial approach to the cerebellopontine angle lesions, vascular and nerve pathologies. This study aims to develop a practical technique for intraoperative mapping of the sigmoid sinus using the topography of the mastoid emissary vein (MEV) canal to improve the accuracy of retrosigmoid craniotomy, and minimize postoperative adverse outcomes.
Materials and methods. Consecutive patients who underwent retrosigmoid approaches for cerebellopontine angle occupying lesions from October 2023 through August 2024 were included in the study. Perioperative computed tomography (CT) was performed with a slice thickness 0.5 mm in the axial plane. The projection of the internal opening of the MEV canal onto the external surface of the mastoid process was determined as the posterior border sigmoid sinus and anterior border for craniotomy. Comparative analyses were performed using t-test and Chi-square test.
Results. A total of 20 patients were operated for neoplasms occupying the cerebellopontine angle using retrosigmoid approach. The average measured distance from the external opening of the MEV canal to the projection of sigmoid sinus posterior border was 9.36 ± 2.17 mm (range 6.3–13.20 mm). The postoperative CT data showed statistically significant differences between the study and control groups in measures of bone window (p = 0.057) and surrounding cranial defect (p < 0.001). The size of bone flaps was slightly similar in all groups (p = 0.114). The mean cranial defect in the study group was almost twice smaller than in the control group 22.4% vs. 44.5% respectively.
Conclusions. This study confirms the utility of mastoid emissary vein canal topography in improving the accuracy of retrosigmoid craniotomy. By facilitating precise sigmoid sinus mapping, the technique reduces the extent of bone removal and minimizes postoperative cranial defect. |
| format | Article |
| id | doaj-art-f0e26fe8ac824dd088a7c58ca9dad553 |
| institution | Kabale University |
| issn | 2663-9084 2663-9092 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Romodanov Neurosurgery Institute |
| record_format | Article |
| series | Ukrainian Neurosurgical Journal |
| spelling | doaj-art-f0e26fe8ac824dd088a7c58ca9dad5532025-01-07T16:05:27ZengRomodanov Neurosurgery InstituteUkrainian Neurosurgical Journal2663-90842663-90922024-12-01304576310.25305/unj.313077Minimizing skull defects in retrosigmoid approach: precision mapping of the sigmoid sinus with mastoid emissary vein canalArtem V. Rozumenko0https://orcid.org/0000-0003-0668-6659Mykola V. Yehorov1https://orcid.org/0000-0002-2257-1715Vasyl V. Shust2https://orcid.org/0000-0002-0459-9888Dmytro M. Tsiurupa3https://orcid.org/0000-0001-7651-5711Anton M. Dubrovka4https://orcid.org/0009-0000-5535-3979Petro M. Onishchenko5Volodymyr O. Fedirko6https://orcid.org/0000-0002-0411-6161Department of Subtentorial Neuro-Oncology, Romodanov Neurosurgery Institute, KyivDepartment of Subtentorial Neuro-Oncology, Romodanov Neurosurgery Institute, KyivDepartment of Subtentorial Neuro-Oncology, Romodanov Neurosurgery Institute, KyivDepartment of Subtentorial Neuro-Oncology, Romodanov Neurosurgery Institute, KyivDepartment of Subtentorial Neuro-Oncology, Romodanov Neurosurgery Institute, KyivDepartment of Subtentorial Neuro-Oncology, Romodanov Neurosurgery Institute, KyivDepartment of Subtentorial Neuro-Oncology, Romodanov Neurosurgery Institute, Kyiv Objective. The retrosigmoid approach is a commonly used cranial approach to the cerebellopontine angle lesions, vascular and nerve pathologies. This study aims to develop a practical technique for intraoperative mapping of the sigmoid sinus using the topography of the mastoid emissary vein (MEV) canal to improve the accuracy of retrosigmoid craniotomy, and minimize postoperative adverse outcomes. Materials and methods. Consecutive patients who underwent retrosigmoid approaches for cerebellopontine angle occupying lesions from October 2023 through August 2024 were included in the study. Perioperative computed tomography (CT) was performed with a slice thickness 0.5 mm in the axial plane. The projection of the internal opening of the MEV canal onto the external surface of the mastoid process was determined as the posterior border sigmoid sinus and anterior border for craniotomy. Comparative analyses were performed using t-test and Chi-square test. Results. A total of 20 patients were operated for neoplasms occupying the cerebellopontine angle using retrosigmoid approach. The average measured distance from the external opening of the MEV canal to the projection of sigmoid sinus posterior border was 9.36 ± 2.17 mm (range 6.3–13.20 mm). The postoperative CT data showed statistically significant differences between the study and control groups in measures of bone window (p = 0.057) and surrounding cranial defect (p < 0.001). The size of bone flaps was slightly similar in all groups (p = 0.114). The mean cranial defect in the study group was almost twice smaller than in the control group 22.4% vs. 44.5% respectively. Conclusions. This study confirms the utility of mastoid emissary vein canal topography in improving the accuracy of retrosigmoid craniotomy. By facilitating precise sigmoid sinus mapping, the technique reduces the extent of bone removal and minimizes postoperative cranial defect.https://theunj.org/article/view/313077 |
| spellingShingle | Artem V. Rozumenko Mykola V. Yehorov Vasyl V. Shust Dmytro M. Tsiurupa Anton M. Dubrovka Petro M. Onishchenko Volodymyr O. Fedirko Minimizing skull defects in retrosigmoid approach: precision mapping of the sigmoid sinus with mastoid emissary vein canal Ukrainian Neurosurgical Journal |
| title | Minimizing skull defects in retrosigmoid approach: precision mapping of the sigmoid sinus with mastoid emissary vein canal |
| title_full | Minimizing skull defects in retrosigmoid approach: precision mapping of the sigmoid sinus with mastoid emissary vein canal |
| title_fullStr | Minimizing skull defects in retrosigmoid approach: precision mapping of the sigmoid sinus with mastoid emissary vein canal |
| title_full_unstemmed | Minimizing skull defects in retrosigmoid approach: precision mapping of the sigmoid sinus with mastoid emissary vein canal |
| title_short | Minimizing skull defects in retrosigmoid approach: precision mapping of the sigmoid sinus with mastoid emissary vein canal |
| title_sort | minimizing skull defects in retrosigmoid approach precision mapping of the sigmoid sinus with mastoid emissary vein canal |
| url | https://theunj.org/article/view/313077 |
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