Abstract
Microsurgical removal of cerebellopontine angle (CPA) tumors, one of the more challenging tasks in neurosurgery, requires advanced skills especially in dealing with bigger tumors. We use the standard sitting position with the patient's head turned and flexed, and our team performs a retrosigmoid craniotomy following a linear incision. The upright position of the patient during the CPA surgery enables spontaneous outflow of blood, cerebrospinal fluid, and solutions used for rinsing the operation site. This position and its consequences restrict the need of coagulation and aspirating nozzle in the operating field. Usage of those surgical instruments often leads to damage to the facial nerve, cochlear nerve, labyrinthine artery, and other delicate structures. The disadvantage of the upright position is risk of pneumatocele or air embolism.
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