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Transfacial transclival approach for midline posterior circulation aneurysms
C S Ogilvy1, F G Barker, M P Joseph
1Neurosurgical Service, Massachusetts General Hospital, Boston, USA.
Neurosurgery
|October 1, 1996
Summary
This study evaluated a novel transfacial transclival approach for treating midline posterior circulation aneurysms. The technique provided excellent surgical exposure with no permanent neurological deficits, though transient cerebrospinal fluid leaks occurred.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Cranial Base Surgery
Background:
- Posterior circulation aneurysms pose significant surgical challenges.
- Minimally invasive approaches are sought to improve outcomes.
Purpose of the Study:
- To assess the efficacy and safety of an anterior, transfacial transclival approach for midline posterior circulation aneurysms.
Main Methods:
- A transfacial approach involving nasal complex disarticulation and clival resection was performed.
- This exposed the vertebral and basilar arteries for aneurysm treatment.
Main Results:
- Excellent exposure was achieved for basilar trunk and posterior inferior cerebellar artery aneurysms.
- Three patients experienced transient cerebrospinal fluid leaks and meningitis, but no permanent neurological morbidity.
- Cosmetic results were excellent, with no palatal dysfunction.
Conclusions:
- The transfacial transclival approach offers excellent exposure for treating midline posterior circulation aneurysms.
- Cerebrospinal fluid leaks and meningitis are potential complications, but manageable with modern antibiotics.