Stephan Herlan1,2, Florian Roser3, Florian H Ebner4, Marcos Tatagiba4. 1. Department of Neurosurgery, Eberhard Karls University Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany. stephan.herlan@med.uni-tuebingen.de. 2. Institute of Clinical Anatomy and Cell Analysis, Eberhard Karls University Tübingen, Elfriede-Aulhorn-Str. 8, 72076, Tübingen, Germany. stephan.herlan@med.uni-tuebingen.de. 3. Neurological Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates. 4. Department of Neurosurgery, Eberhard Karls University Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany.
Abstract
BACKGROUND: Lesions lateral to the lower brainstem in an area extending from the foraminae of Luschka to the foramen magnum are rare and include different pathologies. There is no consensus on an ideal surgical approach. METHOD: To gain access to this area, we use the midline suboccipital subtonsillar approach (STA). This midline approach with unilateral retraction of the cerebellar tonsil enables entry into the cerebellomedullary cistern. CONCLUSIONS: The STA offers excellent access with a panoramic view of the cerebellomedullary cistern and its structures and therefore can be useful for a number of different pathologies in the lower petroclival area.
BACKGROUND: Lesions lateral to the lower brainstem in an area extending from the foraminae of Luschka to the foramen magnum are rare and include different pathologies. There is no consensus on an ideal surgical approach. METHOD: To gain access to this area, we use the midline suboccipital subtonsillar approach (STA). This midline approach with unilateral retraction of the cerebellar tonsil enables entry into the cerebellomedullary cistern. CONCLUSIONS: The STA offers excellent access with a panoramic view of the cerebellomedullary cistern and its structures and therefore can be useful for a number of different pathologies in the lower petroclival area.