Overview: The retromastoid approach is performed through an incision behind the ear and a small bony opening that allows access to the posterior fossa which is an area of the cranium where the cerebellum (for balance and coordination), brainstem and many important nerves reside. Given advances in instrumentation, navigation and endoscopy, this keyhole approach is often used instead of larger traditional skull base approaches. The suboccipital approach, often performed through a midline skin incision is another route frequently used to reach cerebellar and 4th ventricular tumors.  

Disorders Treated: The retromastoid approach is ideal for removal of most acoustic and trigeminal schwannomas, other tumors of the cerebello-pontine angle such as meningiomas and epidermoid cysts, as well as tumors of the cerebellum such as hemangioblastomas and metastatic brain tumors. Depending upon tumor location, a suboccipital craniotomy may be used for cerebellar tumors that are closer to the midline.

Our Experience and Approach: Dr. Daniel Kelly and the BTC team have extensive experience using the retromastoid and suboccipital routes for all types of brain and skull base tumors arising in the posterior fossa. Because of our large experience with both of these approaches as well as other minimally invasive and conventional approaches, we can tailor the optimal approach for each patient.

Multidisciplinary Care: For patients with incompletely removed or aggressive brain or skull base tumors, additional treatments such as radiosurgery and/or chemotherapy may be needed. To learn more, go to Comprehensive Brain Tumor Program.

See more: Endoscopic & keyhole surgery videos on BTC YouTube Channel