Surgical Anatomy and Clinical Complications of Presigmoid Approach

Presigmoid approaches are used for lateral access to the upper and middle third of the clivus and the petrous apex. These approaches provide anterolateral visualization of the brain stem after mobilization of the transvers-sigmoid sinus junction. In comparison to classical subtemporal or paramedian suboccipital approaches, these skull base approaches provide safer and wider surgical access to petroclival region lesions and enable more complete resections. In dealing with tumors in the petroclival region the main goal is maximal safe resection. The complications due to presigmoid approaches are generally temporary and manageable