Posterior Interhemispheric Approach (Occipital Transtentorial Approach: OTA)(<SPECIAL ISSUE>Selection of Surgical Approach and Pitfall II)

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  • Iwama Toru
    Department of Neurosurgery, Gifu University Graduate School of Medicine
  • Yano Hirohito
    Department of Neurosurgery, Gifu University Graduate School of Medicine
  • Nakayama Noriyuki
    Department of Neurosurgery, Gifu University Graduate School of Medicine
  • Ohe Naoyuki
    Department of Neurosurgery, Gifu University Graduate School of Medicine
  • Yoshimura Shinichi
    Department of Neurosurgery, Gifu University Graduate School of Medicine

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  • Posterior interhemispheric approach(occipital transtentorial approach:OTA)(<特集>手術アプローチの選択とピットフォールII-第24回微小脳神経外科解剖セミナーより-)

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The posterior interhemispheric approach (occipital transtentorial approach: OTA) is a useful approach to obtain supra- and infra-tentorial wide operative fields including the splenium, pineal region, quadrigeminal cistern and anterosuperior surface of the cerebellum. Lesions with a downward extension are very suitable for OTA because of its downward trajectory, but lateral lesions are difficult to expose with OTA. For pineal lesions, the Galenic venous complex obstructs the approach route and the anterosuperior part of such lesions is slightly difficult to observe. The occipital lobe and tentorial sinus venous systems are explained as they make up the important microsurgical anatomy for OTA. A comparison between OTA and the infratentorial supracerebellar approach is also discussed.

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