Abstract
Intracranial lesions along the falx and tentorium often require exposure of a dural venous sinus. Craniotomies that cross a sinus should maximize exposure while minimizing the risk of sinus injury and provide a cosmetically appealing result with simple reconstruction techniques. We describe the published techniques for exposing dural venous sinuses, and introduce a new technique for a single-piece craniotomy exposing the superior sagittal sinus or transverse sinus using drilled troughs.A review of the literature was performed to identify articles detailing operative techniques for craniotomies over dural venous sinuses. Our troughed craniotomy for dural sinus exposure is described in detail as well as our experience using this technique in 82 consecutive cases from 2007-2015.Five distinct techniques for exposure of the dural venous sinus were identified in the literature. In our series of patients undergoing a trough craniotomy, there were no sinus injuries despite a range of various locations and pathology along the sagittal and transverse sinuses. Our technique was found to be safe and simple to reconstruct compared to other techniques found in the literature.A variety of different techniques for exposing the dural venous sinuses are available. A single-piece craniotomy using a trough technique is a safe means to achieve venous sinus exposure with minimal reconstruction required. Surgeons should consider this method when removing lesions adjacent to the falx or tentorium.
Highlights
The approach to intracranial lesions adjacent to the major venous sinuses often necessitates complete sinus exposure
Our troughed craniotomy for dural sinus exposure is described in detail as well as our experience using this technique in 82 consecutive cases from 2007-2015
A two-piece craniotomy has been described in which the first portion of the bone flap is elevated adjacent to the sinus, allowing the dura over the sinus to be freed from overlying bone under direct visualization before elevating the second portion of the bone flap over the sinus [7,8]
Summary
The approach to intracranial lesions adjacent to the major venous sinuses often necessitates complete sinus exposure. Visualization of deep midline intracranial lesions benefits from complete exposure of the superior sagittal sinus by substantially increasing the working angle [1]. How to cite this article Gordon W E, Michael ii L, Vanlandingham M A (February 12, 2018) Exposure of Dural Venous Sinuses: A Review of Techniques and Description of a Single-piece Troughed Craniotomy. All techniques for performing a craniotomy over a venous sinus share the common goal of minimizing risk of injury to the underlying sinus. We present our technique of a troughed craniotomy over the sinus in 82 consecutive patients as well as a review of existing techniques to expose the dural sinuses
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