Reconstruction of anterior inferior cerebellar artery by occipital artery through extended retrosigmoid approach

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Objective To explore the feasibility of occipital artery(OA) to anterior inferior cerebellar artery (AICA) through the extended retrosigmoid approach, also perform a systemic microanatomical study of OA and AICA with the exposure of extended retrosigmoid approach, find the easy way to perform the procedure. Methods From September, 2016 to January, 2017, 5 adult cadaveric heads injected with colored latex (total 10 sides) were performed the extended retrosigmoid approach, and measured the caliber of distal occipital artery (OA), the final length of the OA harvest, the reliable landmark of the OA harvest, and the distance from the flocculonodular segment of anterior inferior cerebellar artery (AICA) to the OA, the diameter of AICA flocculonodular segment branch. Whole procedure of OA to IACA bypass also be performed. Statistical analysis was performed. Results By the extended retrosigmoid approach, AICA flocculonodular segment could be easily exposure, the average diameter was 1.2 mm, the OA branch could be harvested in average was (72.3±3.3)mm in length from the occipital sulcus, and the average distance between occipital sulcus and AICA flocculonodular segment was (47.6±1.9)mm. The bypass procedure also could be performed through the proper corridor. Conclusion The Extended retrosigmoid approach is a safe and efficient way to perform the OA-AICA bypass procedure, and the procedure is easier to be performed than other surgical approaches. Key words: Occipital artery; Anterior inferior cerebellar artery; OA-AICA bypass; Extended-retrosigmoid approach; Applied anatomy