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Conservative Posterior Petrosectomy

Last Updated: September 30, 2018

Techniques for Posterior Petrosectomy (Conservative or Minimalistic Approach)

General Considerations

Posterior petrosectomy is the key component of the posterior petrosal approach.  This skull base osteotomy is a combination of 1) temporal craniotomy, 2) posterior petrosectomy, and 3) suboccipital craniotomy.

Posterior petrosectomy involves partial resection of the petrous pyramid to allow access to the petroclival region, anterior cerebellum, and brainstem at the level of cranial nerves (CNs) V-X. In other words, this route facilitates access to the petroclival region bounded by the middle fossa dura superiorly and the jugular bulb inferiorly.

Petroclival lesions above this level are more suited for an anterior petrosectomy. Lesions below the level of the jugular tubercle can be rea...