Inside-out bony window technique for retrosigmoid approach using preoperative 3D planning

Using preoperative 3D reconstruction to project the transverse-sigmoid sinus junction from the inner to outer skull table enables a patient-specific retrosigmoid craniotomy, reducing landmark variability and risk of sinus injury.

• Conventional external landmarks like the asterion are often unreliable due to anatomical variability, risking inaccurate craniotomy and sinus injury.
• This 'inside-out' method personalizes burr hole placement and bone flap design based on individual inner table venous sinus anatomy.
• Technique description with no reported clinical outcomes or comparative safety/efficacy numbers in the provided source.

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