Micro-Doppler for venous sinus localization in approaches to the cerebello-pontine angle

Background Main anatomical landmarks of retrosigmoid craniotomy are transverse sinus (TS), sigmoid sinus (SS), and the confluence of both. Anatomical references and guidance based on preoperative imaging studies are less reliable in the posterior fossa than in the supratentorial region. Simple intra...

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Bibliographic Details
Published in:Acta neurochirurgica 2023-11, Vol.165 (11), p.3467-3472
Main Authors: Barrero Ruiz, Estrella, Ley Urzaiz, Luis
Format: Article
Language:English
Subjects:
Blood flow
Cysts
Dissection
How I Do it
Interventional Radiology
Localization
Magnetic resonance imaging
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Neurology
Neuroradiology
Neurosurgery
Neurosurgery general
Patient positioning
Sinuses
Surgical Orthopedics
Tomography
Ultrasonic imaging
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Summary:Background Main anatomical landmarks of retrosigmoid craniotomy are transverse sinus (TS), sigmoid sinus (SS), and the confluence of both. Anatomical references and guidance based on preoperative imaging studies are less reliable in the posterior fossa than in the supratentorial region. Simple intraoperative real-time guidance methods are in demand to increase safety. Methods This manuscript describes the localization of TS, SS, and TS-SS junction by audio blood flow detection with a micro-Doppler system. Conclusion This is an additional technique to increase safety during craniotomy and dura opening, widening the surgical corridor to secure margins without carrying risks nor increase surgical time.
ISSN:0942-0940
0001-6268
0942-0940
DOI:10.1007/s00701-023-05821-1