Abstract
Modern keyhole surgical approaches of the posterior fossa aim to minimize normal tissue trauma while not compromising surgical views. Minimally invasive endoscopic surgery improves surgeon access to deep-seated pathologies of posterior fossa while providing a panoramic anatomical view with improved illumination. The posterior fossa houses critical neurovascular structures of the brain in an intricate and complex anatomical organization, and lends itself well to keyhole approaches. Five keyhole modules are described in this chapter: (1) Midline supracerebellar-infratentorial to the pineal region, (2) upper cerebellopontine to the trigeminal region, (3) middle cerebellopontine to the vestibulocochlear region and internal auditory meatus, (4) lower cerebellopontine to the jugular foramen region and lower cranial nerves, and (5) midline infracerebellar to posterior foramen magnum and the craniocervical junction. In this chapter, we discuss relevant anatomy, pathology, surgical technique, and advantages of the endoscopic keyhole approaches to the posterior fossa. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022