Advanced Cranial Approaches

Combined petrosal approach

01. Retrolabyrinthine approach and temporal craniotomy. 
Extradural exposure to the Meckel's cave.
02. Combined petrosal approach panoramic view. 
The internal acoustic canal was drilled from the middle fossa exposing the labyrinthine and tympanic segments of the facial nerve, as well as the geniculate ganglion. Anterior petrosectomy was done.
A combined petrosal approach type bone flap was done ezposing the middle fossa. Extradural exposure of the Meckel’s cave and gasserion ganglion was done. The mandibular and maxillary divisions of the trigeminal nerve were exposed. The internal accoustic canal was drilled from middle fossa and the labyrinthine and tympanic segments of the facial nerve, as well as the geniculate ganglion were revealed. Therefore the facial nerve can be followed from the internal accoustic canal to its extracranial branches.