Extradural Anterior Clinoidectomy and Optic Canal Unroofing for Paraclinoid and Basilar Aneurysms: Usefulness of a No-Drill Instrumental Method

Acta Neurochirurgica. Supplement
Koichi IwasakiHitoshi Fukuda

Abstract

The authors describe extradural anterior clinoidectomy without the use of a high-speed drill or ultrasonic device to clip paraclinoid and basilar aneurysms, which can eliminate potential complications related to traditional power drilling or ultrasonic device use. This method involves four steps: (1) partial osteotomy of the sphenoid wing at the superior orbital fissure (SOF); (2) peeling of the dura propria of the temporal lobe from the inner cavernous membrane of the SOF; (3) isolation and resection of the exposed meningo-orbital band to expose the superolateral aspect of the anterior clinoid process (ACP); and (4) piecemeal rongeuring of ACP and the roof of the optic canal. The entire procedure was performed using surgical instruments, including micro-rongeurs, a fine Kerrison punch, and micro-dissectors. Subsequently, intradural neck clipping was performed. Twenty consecutive patients with paraclinoid and basilar aneurysms successfully underwent clipping after this non-drill extradural clinoidectomy. Minor morbidity was noted in two patients (cerebrospinal fluid leakage in one and transient oculomotor palsy in the other). The non-drill method is a simple, easy, safe, and quick alternative to traditional power drilling in ex...Continue Reading

Citations

Nov 24, 2020·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Amparo SaenzAlvaro Campero

❮ Previous
Next ❯

Related Concepts

Related Feeds

Aneurysm

Aneurysms are outward distensions or bulges that occurs in a weakened wall of blood vessels. Discover the latest research on aneurysms here.

CSF & Lymphatic System

This feed focuses on Cerebral Spinal Fluid (CSF) and the lymphatic system. Discover the latest papers using imaging techniques to track CSF outflow into the lymphatic system in animal models.