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Updated: Jun 26, 2026
Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
Cardboard dural retractor for drilling of the sphenoid wing in the pterional approach
Satoru Shimizu1, Hiroyuki Hagiwara, Kenji Nakayama
1Department of Neurosurgery, Yokohama Stroke and Brain Center, Yokohama, Kanagawa 235-0012, Japan. Satoru4756@aol.com
Background:
In the pterional approach, adequate removal of the sphenoid wing is essential. For safe drilling of the medial part, the dura beside the wing is usually retracted with a metal instrument and damage to the instrument may occur. We developed an alternative retraction method that uses a cardboard shield.
Methods:
Before drilling the medial part of the sphenoid wing, a cardboard shield featuring a notch and a bend in its center is prepared. The notch is inserted between the wing to be drilled and the dura.
Results:
The shield retracted the dura beside the wing effectively and provided sufficient space for the diamond drill bit. It held up to the drilling and protected the dura.
Conclusion:
This simple method provides a safe adequate operative field without involving additional instruments or expenditures.
