Incision Design And Clinical Effect Analysis Of The Postauricular C-shaped Incision In Retrosigmoid Approach

Objective: Retrosigmoid approach is a common surgical approach for the treatment of cerebellopontine angle lesions.Different surgical incisions will affect the outcome of the operation.Postauricular C-shaped incision is gradually accepted by clinicians as a convenient,safe,and less complication craniotomy method.Based on the analysis of the surgical effect of this incision and the comparison of different incision,we try to explore the incision design and clinical effect of postauricular C-shaped incision in the retrosigmoid approach.Methods:Retrospective analysis was made on 346 cases of cerebellopontine Angle lesion treated by retrosigmoid approach.There were 33 cases of postauricular C-shaped incision and 313 cases of straight incision.The operative results of 33 patients with postauricular C-shaped incision were analyzed,and the time of craniotomy and the incidence of postoperative complications of different incisions were compared.Results:1 The surgical effect of postauricular C-shaped incision: All 33 cases of postauricular C-shaped incision successfully completed the craniotomy operation,without muscle cutting and serious side injury such as venous sinus rupture,dura tear and so on.The surgical field was well exposed during the operation.After operation,the reduction of bone flap and the tight suture of dura,muscle and skin were achieved,and the anatomic reduction was completed.The incision healed well at discharge and no necrosis in the skin flap.Auricle and occipital skin have no sensory dysfunction and numbness.2 The open and close craniotomy time of postauricular C-shaped incision was shorter than that of straight incision.The difference is statistically significant(P < 0.05).1 case subcutaneous effusion,and no cerebrospinal fluid leakage and incision infection occurred in postauricular C-shaped incision surgery.Total 1 case,the incidence of complications was 3.0%.13 cases of cerebrospinal fluid leakage,34 cases of subcutaneous effusion and 6 cases of incisional infection occurred in straight incision surgery.Total 50 cases(1 case with 2 or more complications at the same time),The incidence of complications was 16.0%.The incidence of postoperative complications of postauricular C-shaped incision was lower than that of straight incision,the difference was statistically significant(P < 0.05).Conclusion:The postauricular C-shaped incision can be used in retrosigmoid approach with simple operation,no muscle cutting,easy formation of bone flap,good exposure of visual field.Compared with straight incision,the open and close craniotomy are faster,less complications,and can achieve good clinical effect.