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A Standard Operation Procedure of Clean and Fast Craniotomy Technique for Retrosigmoid Approach

Chen, Songyu MD*,†; Yang, Ning MD, PhD*,‡; Li, Weiguo MD*,‡; Xu, Shujun MD*,‡; Li, Xingang MD, PhD*,‡; Ma, Xiangyu MD, PhD*,‡

doi: 10.1097/SCS.0000000000005410
Clinical Study: PDF Only

Clean and fast craniotomy and closure (CAC) for retrosigmoid approach with safe and satisfactory exposure remains our primary goal. A standard operation procedure (SOP) of retrosigmoid approach was developed and reviewed. Between January 2015 and January 2017, 97 patients suffering various lesions underwent surgeries using this technique in the Department of Neurosurgery, Qilu Hospital of Shandong University. The records concerning time of craniotomies, blood losses, and complications were reviewed. By applying this SOP, a craniotomy generally took 15 to 35 minutes, with an average of around 25 minutes. Six cases had a blood loss of more than 30 mL during craniotomy. One patient had cerebrospinal fluid rhinorrhea and another case had subcutaneous effusion. There was no record of venous sinus injury or wound infection. To sum up, the SOP of retrosigmoid approach is simple, reliable and bloodless. In addition to avoiding complications such as venous sinus injury effectively, the SOP also benefits training of residents and early recovery after surgery (ERAS).

*Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan

Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University, Shanghai

Brain Science Research Institute, Shandong University, Jinan, China.

Address correspondence and reprint requests to Dr Xiangyu Ma, MD, PhD, Department of Neurosurgery, Qilu Hospital of Shandong University, 107# Wenhua West Road, Jinan 250012, China; E-mail:

Received 12 May, 2018

Accepted 14 January, 2019

The work was supported by National Natural Science Foundation of China (No. 81201986), foundation for outstanding young and middle-aged scientists of Shandong province (No. BS2013YY018), Scientific and Technological Innovation Plan for Clinical Medicine of Jinan City (201805037) and China Postdoctoral Science Foundation (2018M642661).

The authors have no conflicts of interest to disclose.

© 2019 by Mutaz B. Habal, MD.