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The extradural extended eyebrow approach: A cadaveric feasibility study.
R Martínez-Pérez1, D A Hardesty2, D M Prevedello2
1Department of Neurological Surgery, The Ohio State University, Wexner Medical Center, 410W. 10th Ave., N-1049 Doan Hall, Columbus, OH 43210, United States.
Neuro-Chirurgie
|December 6, 2020
Summary
The extradural extended eyebrow approach (xEBA+eAC) offers a feasible technique for extradural anterior clinoidectomy (eAC). This modified supraorbital approach successfully exposes the paraclinoid region, crucial for neurosurgical procedures.
Area of Science:
- Neurosurgery
- Surgical Anatomy
Background:
- Extradural anterior clinoidectomy (eAC) is essential for paraclinoid region exposure.
- Limitations exist with standard supraorbital craniotomy for eAC.
Purpose of the Study:
- To provide educational material on a modified supraorbital approach.
- To discuss technical nuances of the extradural extended eyebrow approach with extradural anterior clinoidectomy (xEBA+eAC).
Main Methods:
- Anatomical dissection of four embalmed heads.
- Surgical approach demonstration using one additional head for video recording.
Main Results:
- Successful removal of the anterior clinoid process and exposure of the paraclinoid region, including the ophthalmic artery.
- Key steps involve drilling the sphenoid wing, interdural dissection, and specific osteotomies for clinoid removal.
- Sectioning the distal dural ring aids internal carotid artery mobilization and ophthalmic artery exposure.
Conclusions:
- The xEBA+eAC is a technically viable surgical approach.
- This method provides adequate exposure to the paraclinoid, anterior, and middle cranial fossae.
