[Hemostasis].

Abstract

Hemostasis is a critical skill in cerebellopontine angle (CPA) tumor surgery given its deep anatomical location, narrow surgical corridor, and proximity to vital neurovascular structures. Inadequate bleeding control can obscure the operative field, increase the risk of cranial nerve injury, and lead to life-threatening complications, such as brainstem infarction or cerebellar swelling. This article outlines the key principles of hemostasis at each step of CPA tumor resection, from the preoperative setting and craniotomy to tumor debulking and dissection. Based on our surgical experience, we present detailed technical strategies for achieving safe and effective hemostasis during meningioma, vestibular schwannoma, and hemangioblastoma resection. Practical tips include the management of emissary veins; the preservation of draining veins, such as the petrosal vein; and staged tumor resection adapted to the vascular supply. Videos of representative cases are included to demonstrate hemostatic techniques in real surgical settings. Through emphasizing complete bleeding control at each stage before proceeding to the next, this article aims to provide practical guidance for neurosurgeons in training and promote safer skull base tumor surgery.