Skull Base Surgery of the Posterior Fossa

23

References

1. Rhoton AL Jr. Rhoton’s cranial anatomy and surgical
   approaches. 1st ed. Philadelphia: Lippincott Williams
   & Wilkins; 2007.


2. http://rhoton.ineurodb.org.


3. Rhoton AL Jr. The posterior fossa veins. Neurosurgery.
   2000;47:69–92.


4. Yasargil MG, Kasdaglis K, Jain KK, Weber HP.
   Anatomical observations of the subarachnoid cisterns of
   the brain during surgery. J Neurosurg. 1976;44:298–302.
   5. Stein BM. Supracerebellar-infratentorial approach to
   pineal tumors. Surg Neurol. 1979;11:331–7.
   6. Mussi A, Rhoton AL Jr. Telovelar approach to the
   fourth ventricle: microsurgical anatomy. J Neurosurg.
   2000;92:812–23.
   7. Rhoton AL Jr. The cerebellopontine angle and poste-
   rior fossa cranial nerves by the retrosigmoid approach.
   Neurosurgery. 2000;47:93–129.
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Fig. 1.12 Anterior approaches. (a) The transbasal
approach through the anterior skull base, midface sinuses
and nasal cavity can provide exposure of the clivus and
pterygopalatine fossa. The clivus can then be opened to
expose the posterior fossa. In this specimen, the prepon-
tine cistern and the pontomedullary junction are visual-
ized. The cavernous segment of the carotid is seen
laterally. (b) The expanded endonasal approach through
the clivus can expose the anterior aspect of the posterior
fossa from the interpeduncular fossa to the foramen mag-

num. Exposure of lateral structures seen in this dissection

is more challenging. (c) The endoscopic transoral

approach provides a similar exposure to the endonasal

approach, though with a more foreshortened perspective

superiorly due to a more extreme angle. (d) The trans-

maxillary approach provides a slightly lateral perspective

through the maxillary sinus to expose the anterior aspect

of the posterior fossa, the pterygopalatine fossa, and the

infratemporal fossa. A facial incision has been made in

this specimen, but a degloving incision is also possible

1 Surgical Anatomy of the Posterior Fossa