Retrosigmoid approach assisted by high-resolution computed tomography: a cost-effective technique to identify the transverse and sigmoid sinus transition  

作　　者：Wang Runfeng Zhang Zhiguo Li Zhihong Qu Yan 

机构地区：[1]Tangdu Hospital,Air Force Military Medical University,No.1,Xisi Road,Baqiao District,Xi’an City,China

出　　处：《Chinese Neurosurgical Journal》2020年第3期127-132,共6页中华神经外科杂志（英文）

摘　　要：Background:When utilizing the retrosigmoid approach(RA),accurately identifying the transverse and sigmoid sinus transition(TSST)is a key procedure for neurosurgeons,especially in developing countries restricted by the lack of expensive devices,such as the neural navigation system and the three-dimensional volumetric image-rendered system.Before operations,a computed tomography scan is a common and cost-effective method of checking patients who suffer lesions located at the cerebellopontine angle.Therefore,we present a technique using only high-resolution computed tomography to identify the transverse and sigmoid sinus transition.Methods:This retrospective study included 35 patients who underwent retrosigmoid approach operations to resect an acoustic neurinoma with the assistance of our technique.In brief,our technique contains 4 steps:(1)All patients’1-mm,consecutive,high-resolution computed tomographic images that clearly displayed landmarks,such as the inion,lambdoid suture,occipitomastoid suture,and the mastoid emissary foramen,were investigated initially.(2)We selected two particular slices(A and B)among all of these high-resolution computed tomographic images in which scanning planes were parallel with the line drawn from the root of the zygoma to the inion(LZI).Slice A contained both the root of the zygoma and the inion simultaneously,and slice B displayed the mastoid emissary foramen.(3)Four points(α,β,γ,δ)were arranged on slices A and B,and pointαwas located at the inner surface of the skull,which represents the posterior part of the sulci of the sigmoid sinus.Pointβwas located at the outer surface of the skull,and the line connecting them was perpendicular to the bone.Similarly,on slice B,we labeled pointγas the point that represents the posterior part of the sulci of the sigmoid sinus at the inner surface and pointδas the point located at the outer surface of the skull,and the line connecting them was also perpendicular to the bone.The distances between pointβand the lambdoid suture/occipitom

关 键 词：Retrosigmoid approach Transverse and sigmoid sinus transition Lambdoid suture Occipitomastoid suture LZI Mastoid emissary foramen 

分 类 号：R651.1[医药卫生—外科学]