Universität zu Köln

Stavrinou, Pantelis, Drosos, Evangelos ORCID: 0000-0002-0456-7317, Komaitis, Spyridon, Skandalakis, Georgios P., Mazarakis, Nektarios K., Kalyvas, Aristotelis, V, Troupis, Theodore, Goldbrunner, Roland, Stranjalis, George and Koutsarnakis, Christos (2022). Direct Comparison Between the Kawase Approach and Retrosigmoid Intradural Suprameatal Corridor to Access the Petroclival Region Using Computed Tomography Quantitative Volumetric Analysis: A Cadaveric Study. World Neurosurg., 166. S. E841 - 9. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-8769

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Abstract

OBJECTIVE: The anterior petrosectomy, also known as the Kawase approach, and the retrosigmoid intradural suprameatal approach (RISA) have both been used to reduce the petrous apex and access the petroclival region. Our goal was to compare the volumes and 3-dimensional shapes of bony resection obtained through each approach while trying to resemble realistic surgical settings. METHODS: Five cadaveric specimens totaling 10 sides were dissected and analyzed. In every specimen, 1 side was used for the Kawase approach while the opposite side was used for the RISA. Petrosectomy volumes were assessed by comparing preoperative and postoperative thin-sliced computed tomography scans. RESULTS: Petrosectomy volumes were significantly larger through the Kawase approach than through the RISA (0.82 +/- 0.11 vs. 0.49 +/- 0.07 cm(3), P < 0.001). In addition, surgical maneuverability and freedom were greater in the Kawase operative variant. Lastly, the morphology of the bony window achieved through each approach was clearly different: trapezoid for the anterior petrosectomy versus elongated ellipsoid for the RISA. CONCLUSIONS: The Kawase approach invariably results in larger volumes of bony removal than the RISA operative variant, and the volume of petrosectomy that is spatially congruent is only partially identical. The Kawase corridor is best suited for middle fossa lesions that extend into the posterior fossa, while the RISA is suitable for pathologies mainly residing in the posterior fossa and extending into the Meckel cave.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Stavrinou, Pantelis UNSPECIFIED UNSPECIFIED UNSPECIFIED Drosos, Evangelos UNSPECIFIED orcid.org/0000-0002-0456-7317 UNSPECIFIED Komaitis, Spyridon UNSPECIFIED UNSPECIFIED UNSPECIFIED Skandalakis, Georgios P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mazarakis, Nektarios K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kalyvas, Aristotelis, V UNSPECIFIED UNSPECIFIED UNSPECIFIED Troupis, Theodore UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Stranjalis, George UNSPECIFIED UNSPECIFIED UNSPECIFIED Koutsarnakis, Christos UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-690329
DOI:	10.1016/j.wneu.2022.07.120
Journal or Publication Title:	World Neurosurg.
Volume:	166
Page Range:	S. E841 - 9
Date:	2022
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1878-8769
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MIDDLE FOSSA APPROACH; PETROUS APEX; TRANSTENTORIAL APPROACH; CRANIAL FOSSA; POSTERIOR; MENINGIOMAS; TUMORS; EXPERIENCE; DIAGNOSIS; ANEURYSMS Multiple languages Clinical Neurology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69032