Abstract
Background. In modern neurosurgery, preference is given to less invasive procedures. A classic example is switching from standard surgical approaches to keyhole approaches, in particular transition from pterional to minipterional approach. In turn, addition of extradural resection of the anterior clinoid process to the minipterional approach significantly expands the range of its indications.Method. The paper analyses the stages and main features of microsurgical clipping of carotid-ophthalmic aneurysms through the minipterional approach with extradural anterior clinoidectomy in patients operated in the Federal Centre of Neurosurgery (Tyumen, Russia) by professor Sufianov.Conclusion. The technique described in this research is a safe surgical approach, which demonstrates the efficacy of adding some skull base surgery elements to keyhole approaches. This type of craniotomy could become a method of choice for many neurosurgical conditions.
Highlights
In modern neurosurgery, preference is given to less invasive procedures
Note: A – aneurysm; Clips – clips are placed on the neck of the aneurysm; OA – ophthalmic artery; ICA – internal carotid artery; ON – optic nerve
The risk of intraoperative aneurysm rupture is increased by extradural clinoidectomy, and the patient should be informed of this before the operation, but the risk is still low, and such complications have not occurred in our practice
Summary
Note: A – aneurysm; Clips – clips are placed on the neck of the aneurysm; OA – ophthalmic artery; ICA – internal carotid artery; ON – optic nerve. Примечание: A (aneurism) – аневризма; Clips – наложенный на шейку аневризмы клипс; OA (ophthalmic artery) – офтальмическая артерия; ICA (internal carotid artery) – внутренняя сонная артерия; ON (optic nerve) – зрительный нерв. The small size of the craniotomy makes it difficult for two neurosurgeons to work simultaneously, which requires relevant surgical training and experience, along with appropriate neurosurgical instruments. The risk of intraoperative aneurysm rupture is increased by extradural clinoidectomy, and the patient should be informed of this before the operation, but the risk is still low, and such complications have not occurred in our practice. If the operating surgeons have enough experience, the risk is insignificant and such cases have not occurred in our series
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