Computed Tomography Venography For Planning Suboccipital Retrosigmoid Craniotomy

ObjectivesTo evaluate the clinical application of cranial CT venography (CTV) in the suboccipital retrosigmoid craniotomy.MethodsA series of68consecutive patients who were surgically treated with suboccipital retrosigmoid approach from June2011to December2012in our hospital were enrolled in this study. Cranial CTV was performed for every patients preoperatively, by marking the projection of transverse and sigmoid sinus junction (TSSJ) on the skull surface to guide the craniotomy, and we compared the actual position of transverse and sigmoid sinus intraoperation with the preoperative marker of CTV. Time of surgery, sinus injury and any other complications were recorded. ResultsAll the procedures of craniotomy including removal of the bone flap were accomplished smoothly and safely within39minutes on average. Generally, The site of TSSJ on CTV was in good agreement with that assessed in surgery. No sinus injury happened in the surgery, surgical field was exposured satisfying, Postoperatively no complications such as subcutaneous hydrocele, cerebrospinal fluid leakage or intracranial infection occurred. The skull had good appearance without defects, postoperative CTV showed the bone flap repositioned well.ConclusionsThe simple, reliable cranial CTV based method could help in localizing the TSSJ, and avoiding the risk of sinus injury and reducing the bone defect in patients undergoing a suboccipital retrosigmoid craniotomy. We consider the cranial CTV as an useful method in preoperative planning, which is safer and more efficient in suboccipital retrosigmoid craniotomies.