Application of craniotomy under microscope in individualized small incision via retrosigmoid approach

GAN Wu; ZHAN Sheng-quan; GUO Wen-long

doi:10.13820/j.cnki.gdyx.20225608

Abstract：Objective To investigate the application effect and feasibility of microsurgical training of craniotomy under microscope in individualized small incision via retrosigmoid approach.Methods A retrospective analysis was con-ducted on data from cases of microscopic craniotomy under an individualized small incision retrosigmoid approach,consec-utively performed by the same surgeon in the Department of Neurosurgery at the People's Hospital of Guangdong Province from September 2020 to March 2022.Patient information,diagnosis,incision length,craniotomy time and blood loss,postoperative review,incision-related complications,and follow-up information on incision healing and related compli-cations were collected.A total of 43 patients were included,consisting of 13 males and 30 females,with ages ranging from 25 to 72 years and individualized incision lengths ranging from 3 to 7 cm.Results All 43 cases were successfully per-formed according to preoperative plans,with no insufficient exposure during the procedure,no extension of the incision,no enlargement of bone flaps,no use of scalp clips,and no postoperative drainage tube placement.A technique that did not require suture removal was employed.The craniotomy time ranged from 17 to 42 minutes,with an average of(25.2± 3.8)minutes,and the closure time ranged from 14 to 50 minutes,with an average of(25.6±8.3)minutes.During the 1 to 19 months of follow-up,only one patient with vestibular schwannoma experienced intracranial infection and cerebro-spinal fluid leakage one month postoperatively.This patient underwent surgical repair and recovered after antimicrobial therapy.No cases of incision redness,suppuration,or incision dehiscence were observed.Conclusion Microscopic cra-niotomy under an individualized small incision retrosigmoid approach is safe and effective,aligning with the principles of precise minimally invasive surgery and the trend of rapid recovery.It serves as an effective method for training young sur-geons in microscopy.