Journal Information
Vol. 19. Issue 2.
Pages 133-142 (January 2008)
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Vol. 19. Issue 2.
Pages 133-142 (January 2008)
The partial labyrinthectomy petrous apicectomy approach to petroclival meningiomas. A quantitative anatomic comparison with other approaches to the same region
La laberintectomia parcial con apicectomía petrosa como acceso a los meningiomas petroclivales. Una comparación anatómico - quantitativa con otras vías de abordaje a la misma zona
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C. Mandelli
, G.M. Sicuri, I. Lomonaco
Department of Neurosurgery. IRCCS San Raffaele. Università Vita-Salute. Milano. Italy
L. Porras*, C. López-Sánchez**, V. García-Martínez**
* Department of Neurosurgery. Universidad de Extremadura. Badajoz. Spain
** Infanta Cristina Hospital. Badajoz. Spain. Department of and Anatomy. Universidad de Extremadura. Badajoz. Spain
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Summary

The partial labyrinthectomy petrous apicectomy (PLPA) approach is a transpetrous route that provides the advantages of the labyrinthine removal but with hearing preservation. Using seven temporal bone tissue blocks and three formaldehyde-fixed cadaveric heads we have made a morphometric and comparative study on this approach that summarizes the invasiveness, the optimal surgical exposure, the anatomic complexity of the skull base approaches and, on the other hand, the spirit of preservation that is the constant aim of modern neurosurgery. The morphometric analysis is designed to make the bony phase of the PLPA approach safer and to define the relationship between petrous landmarks. The comparative study is made between the PLPA and other neurosurgical routes enhancing the potentiality of the PLPA approach that permits a wider angle of incidence towards the brainstem than with the retrosigmoid routes.

Key words:
Meningioma
Partial labyrinthectomy
Petroclival
Petrosal approach
Rretrosigmoid approach
Abreviaturas:
EAC
ETCA
FN
ICA
PLPA
RISTA
RS
SD
SS
Resumen

La laberintectomía parcial con apicectomía petrosa (PLPA) es una vía de abordaje que proporciona las ventajas de la extirpación parcial del laberinto preservando la audición. Trabajando sobre 7 piezas anatómicas de hueso temporal y 3 cabezas de cadáver fijadas con formaldehido, hemos realizado un estudio morfométrico y comparativo de este abordaje interesándonos los aspectos de la invasividad del abordaje, óptima exposición quirúrgica obtenida, complejidad anatómica de la entrada a la base craneal, y por otra parte, la actitud conservadora de la moderna neurocirugía. El análisis morfométrico tiene como objetivo hacer la fase ósea de la PLPA más segura al definir la relación entre los puntos de referencia petrosos. El estudio comparativo entre la PLPA y otros abordajes neuroquirúrgicos exalta la posibilidades de la PLPA ya que proporciona un ángulo de incidencia hacia el tronco cerebral má°s amplio que el que proporcionan las vías retrosigmoideas.

Palabras clave:
Meningioma
Laberintectomía parcial
Petroclival
Abordaje petroso. Abordaje retrosigmideo

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