Trans-cochlear approach

                                     to Lt. petroclival tumor:

Dr. C. Rayappa,     visit www.headneckskullbase.com
E.N.T & Skull base surgeon, Apollo Hospitals, Chennai, India.   
                                                                                                                                        
                                                                                                                                             
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Clip1:

Tympanic membrane and ossicles are removed.

Mastoidectomy is done; the sigmoid sinus, and the mastoid segment of the facial nerve are skeletonized.

Clip2:

Labyrinthectomy is in progress; Tympanic segment, and labyrinthine segment of the facial nerve are skeletonized.

IAM is deroofed.

Clip3:

GSPN is cut and the facial nerve is rerouted posteriorly.

Cohlea, petrous apex, & clivus are drilled out.

Tumor is seen after transsigmoid incision the dura.

After tumor excision, brainstem, and basilar artery are visualized.

 

 

 

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