Skull Base Surgery of the Posterior Fossa

146

Surgical Technique

The steps of the retrosigmoid technique for hear-
ing preservation are illustrated in Fig. 11.1, and
those for the non-hearing preservation procedure
are illustrated in Fig. 11.2. At our institution, we
use the lateral position with the head held in a

Mayfield three-point pin headrest. We try to min-

imize the rotation of the head and flex the neck in

a lateral direction to offer increased working dis-

tance between the suboccipital region and the

upper shoulder of the nondependent arm. The

arm is placed on an airplane rest and retracted

gently inferiorly. An axillary roll and a Foley

Fig. 11.1 (continued)

G. Alzhrani et al.