ObjectiveTo study the anatomical application of craniotomy via retrosigmoid approach with three-dimensional CT localization, and to provide a minimally invasive and safe surgical approach for clinical practice. MethodsAfter accurate localization of transverse-sigmoid sinus junction (TSSJ) using three-dimensional CT reconstruction technique, individualized craniotomy via retrosigmoid approach was performed in 23 patients with cerebellopontine angle disease, concurrently, 12 skull specimens (24 sides) received localization with the same method and then underwent craniotomy for further anatomical verification. ResultsThe “key hole” was located in the medial margin of TSSJ among all of the 23 patients with cerebellopontine angle disease and 12 (24 sides) skull specimens. No sigmoid sinus or transverse sinus injury cases were observed, after craniotomy, inferior margin of transverse sinus sulcus, medial margin of sigmoid sinus sulcus, and TSSJ got satisfactory exposure; intraoperative bone flap restoration was favorable, skull defect was significantly ameliorated, No subcutaneous hydrops, cerebrospinal fluid leakage in incision, or intracranial infection occurred in the 23 patients. ConclusionApplication of accurate three-dimensional CT localization to craniotomy via suboccipital retrosigmoid approach has the advantages of safety, rapidity and minimal invasion, and it is worthy of clinical promotion and application.

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