Functional Surgery of Cerebellopontine Angle by Minimally Invasive Retrosigmoid Approach

Functional Surgery of Cerebellopontine Angle by Minimally Invasive Retrosigmoid ApproachBy

  • Jacques Magnan MD
  • Bhavin Parikh MS (ENT) Fellowship in Otology
  • Hidemi Miyazaki MD (ORL)
The purpose of this book is to discover, popularize and practice the retrosigmoid approach as it was originally conceived “by otologists for otologists”, but of course it can be used by all surgical specialties involved with pathologies of the cerebellopontine angle. To understand why this approach has become indispensable for us, i.e. the otologists, we have to go back in time. During the 1970s, the operating microscope was widely used in all ENT centers, while its utility was just appearing in neurosurgery. The original concept of the “a minima” (French word for minimally invasive) retrosigmoid approach was to adapt the techniques of microsurgery of ear to surgery of the acousticofacial nerve bundle. Another purpose of developing the retrosigmoid approach was to reduce morbidity so as to distinguish it from the legendary seriousness of the suboccipital approach.
Functional disorders of cerebellopontine angle (CPA) include conditions that are not life threatening but at the same time severely affecting the quality of life of affected patients, especially in elderly population. The purpose of these surgeries is to improve the quality of life of the patients and reducing the unacceptable complications. The book Functional Surgery of Cerebellopontine Angle by Minimally Invasive Retrosigmoid Approach is based on the surgical experience of more than 2000 cases using this approach handled by Professor Jacques Magnan over the last 40 years. This book attempts to present the update on the current surgical management of functional disorders of CPA in a concise, “step by step” and “How I do it”format. The book includes 540 excellent color digital operative endoscopic and microscopic photographs for illustrating the magnificent and previously unforeseen anatomy and pathology of CPA. This comprehensive text and atlas attempts to provide detail description of this endoscope-assisted microscopic approach for all functional conditions, like Meniere’s disease (vestibular neurotomy), small and medium acoustic neuromas and vascular compression syndromes, like trigeminal neuralgia and hemifacial spasm. A separate chapter on newer method of continuous cochlear and facial nerve monitoring and mapping and its applications in each of these conditions will be bringing a paradigm shift in indications and surgical management of these conditions. It would serve as a handy text and guide for the neurologists, electrophysiologists, otorhinolaryngologists, neuro-otologic surgeons and neurosurgeons who are interested in the pathologies related to the cerebellopontine angle.


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