Application of three-dimensional CT cranial bones reconstruction technique to surgery through suboccipital retrosigmoid approach
LUO Zheng-xiang
LIU Ying-liang
ZHANG Wen-bin
YANG Kun
HU Xin-hua
ZOU Yuan-jie
ZHANG Yan-song
KAN Wen-wu
Abstract：Objective To investigate the role of three-dimensional CT (3D-CT) cranial bones reconstruction technique in the surgery through suboccipital retrosigmoid approach. Methods The clinical data of 40 patients with cerebellopontine angle lesions treated by surgery through suboccipital retrosigmoid approach from December, 2014 to March, 2017 were analyzed retrospectively. The lesions were in the left sides of the brains in 22 patients and in the right sides in 18. The cranial bones and cranial fossa were preoperatively reconstructed by 3D-CT reconstruction technique in all the patients. The transverse sinus, sigmoid sinus sulcus, asterion, anterior horn of parietomastoid sutures, occipitomastoid suture and digastric groove were ascertained on 3D model of head. The 'key hole' on the inner surface of the skull was designed under the help of transverse sinus and sigmoid sinus junction. The angle and distance between the 'key hole' and anterior horn of parietomastoid sutures, or asterion, or digastric groove on the external surface of the skull were measured. Craniotomy was performed according to the preoperative plan. Results There were no intraoperative venous sinus rupture and obvious bone defect. The craniotomy was quick. The 'key hole' was clearly exposed at the junction of transverse sinus and sigmoid sinus in 34 patients and not in 6 patients. The distance between the center of the 'key hole' and left asterion ranged from 6.7 to 20.6 mm [mean, (14± 3.6) mm] and the distance between the centre of the 'key hole' and the right asterion ranged from 6.9 to 19.4mm [mean, (13.9±3.7) mm]. The left and right angles between the line connecting the asterion and the centre of the 'key hole' and line connecting the asterion and digastric groove ranged from 4° to 45° (mean 25° ± 12° ) and from 4° to 49° (mean, 24° ± 13° ) respectively. Conclusions The 3D-CT cranial bone reconstruction technique is easy and can be used in the patients with intracranial lesions undergoing surgery through suboccipital retrosigmoid approach, in whom less defect of bone flap and good protection of venous sinus can be realized by 3D-CT cranial bone reconstruction technique.
Keywords：Cerebellopontine angle lesionsCraniotomyRetrosigmoid approachThree-dimensional CTSkullReconstruction
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 630-633 )