THE MASTOID AIR cell was illuminated to estimate the location of the s
igmoid sinus in 12 cases of a retrosigmoid suboccipital craniotomy for
cerebellopontine angle tumors. A special illuminator system was desig
ned, and the tip of the illuminator was placed inside the external aud
itory canal. The posterior margin of the illuminated air cell was deli
neated on the outer surface of the skull after the skin flap was turne
d and the position of the sigmoid sinus was estimated with reference t
o the preoperative computed tomographic scan. The posterior margin of
the mastoid air cell in an axial slice, including the internal auditor
y canal, usually exists within the breadth of the sigmoid sinus. A gap
between the posterior margin of the mastoid air cell and the position
of the sigmoid sinus was easily corrected by the computed tomographic
finding. This method was found to be simple and reliable in performin
g the suboccipital craniotomy with safety and exactness.