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Updated: Apr 18, 2026

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
Transfrontal sinus approach for an anterior cranial fossa, ethmoidal, dural arteriovenous fistula
Elsa Magro1, Doortje Engel1, Michel W Bojanowski1
1Division of Neurosurgery, Department of Surgery, Centre Hospitalier de l'Université de Montréal - Hôpital Notre-Dame, Montreal, Quebec, Canada.
Background:
Ethmoidal dural arteriovenous fistulas (eDAVFs) are usually approached via a pterional or a frontal craniotomy. A more direct route to the fistula is possible through a purely transfrontal sinus approach. The aim of this report is to illustrate the interest of transsinus frontal approach for eDAVFs.
Case Description:
The transfrontal sinus approach is described and illustrated in a case of an ethmoidal arteriovenous fistula. This approach is the most direct when treating an eDAVF surgically, allowing preserving neural structures with minimal to no brain manipulation.
Conclusion:
For eDAVFs, the purely transfrontal sinus approach is highly worth considering in cases of large frontal sinuses.
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