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Updated: Feb 22, 2026

Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Extradural clinoidectomy for resection of clinoidal meningioma
Simon Buttrick1, Jacques J Morcos1, Mohamed S Elhammady1
1Department of Neurological Surgery, University of Miami, Florida; and.
Abstract:
Extradural anterior clinoidectomy is a versatile technique to increase exposure of the sellar and parasellar region. It is of particular use in the resection of clinoidal meningiomas, as sphenoidal and clinoidal hyperostosis can cause compression of the optic nerve. Extradural clinoidectomy follows a series of steps, consisting of (1) unroofing of the superior orbital fissure, (2) unroofing of the optic canal, (3) removal of the optic strut, and (4) removal of the anterior clinoid process. The authors show these steps in detail, as well as their application to the resection of a large clinoidal meningioma. The video can be found here: https://youtu.be/O1Fcef29ETg .
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