Anterior Petrosectomy and Resection of a Meckel's Cave Schwannoma

Video Type: CVideo
  • 2-5 min videos of a particular surgery or technique. These again show major events in the surgery
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  • These have clear but concise abstracts are not able to be indexed in PubMed
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Author: Walter Jean
Published:
Specialties: Neurosurgery
Schools: Georgetown University Hospital
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Basic Info

Contributors: Daniel Felbaum and  H. Jeff Kim

The video demonstrates the resection of a trigeminal schwannoma via a middle fossa craniiotomy and anterior petrosectomy. A large dumbbell-shaped tumor was essentially two tumors in one. The anterior petrosectomy provided access mainly to the posterior component of the tumor, which was compressing the pons, and obscured by the tentorium and petrous ridge. Mobilization of the lateral wall of the cavernous sinus freed the  anterior component and thus allowed the removal of the rest of the schwannoma.

DOI# http://dx.doi.org/10.17797/8hbvtjdj0l

Advanced

Procedure

Middle fossa craniotomy, anterior petrosectomy, resection of a Meckel's cave tumor

Indications

Resection of a mass lesion straddling the anterior petrous ridge, with components in both the middle and posterior fossa

Contraindications

Instrumentation

Setup

Facial nerve monitor

Preoperative Workup

MRI, thin-cut CT of the temporal bone

Anatomy and Landmarks

Foramen ovale, Kawase's region, lateral wall of the cavernous sinus

Advantages/Disadvantages

Advantage: allows exposure to the anterior petrous ridge and posterior cavernous sinus
Disadvantage: technically challenging, retraction on the temporal lobe

Complications/Risks

Risks include facial numbness, potential diplopia, facial palsy, seizure

Disclosure of Conflicts

Risks include facial numbness, potential diplopia, facial palsy, seizure

Acknowledgements

References

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