Posterior fossa craniotomy for lesions of the cerebellopontine angle

Technical note

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✓ A safe technique is described for performing a lateral posterior fossa craniotomy to gain access to the cerebellopontine angle. The method makes use of currently available high-speed air drills. Thus, it is possible to replace the removed bone at the conclusion of the procedure and to re-establish normal tissue planes while providing rigid protection to the posterior fossa.

Article Information

Address reprint requests to: Christopher S. Ogilvy, M.D., Neurosurgical Service, Massachusetts General Hospital, Fruit Street, Boston, Massachusetts 02114.

© AANS, except where prohibited by US copyright law.

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    Artist's drawing showing creation of a free bone flap to gain access to the right cerebellopontine angle. A No. 3 Penfield dissector is placed through the burr hole. After the dura is carefully stripped, the diamond-tipped drill is used to create small holes around the periphery of the planned craniotomy. The upper holes define the course of the transverse sinus. A craniotome is then used to connect the small holes and complete the craniotomy. This bone flap is wired back into place at the conclusion of surgery. The inset shows the skin incision and bone flap with a patient positioned for surgery. M. = muscle.

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