The suboccipital, telovelar, transsuperior fovea approach to dorsal pontine lesions
Channel: American Association of Neurological Surgeons
Date: 2020-08-06

M. Yashar S. Kalani, MD, PhD, Kaan Yağmurlu, MD, Nikolay L. Martirosyan, MD, PhD, and Robert F. Spetzler, MD

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona

Abstract
Dorsal pons lesions at the facial colliculus level can be accessed with a suboccipital telovelar (SOTV) approach using the superior fovea safe entry zone. Opening the telovelar junction allows visualization of the dorsal pons and lateral entry at the level of the fourth ventricle floor. Typically, a lateral entry into the floor of the fourth ventricle is better tolerated than a midline opening. This video demonstrates the use of the SOTV approach to remove a cavernous malformation at the level of the facial colliculus. This case is particularly interesting because of a large venous anomaly and several telangiectasias in the pons. Dissections in the video are reproduced with permission from the Rhoton Collection (http://rhoton.ineurodb.org).


**Intro music: "Daybreak" by Graeme Rosner