Modified extradural selective anterior clinoidectomy leaving the optic canal unopened for internal carotid aneurysms: A technical note

Background: Anterior clinoidectomy is an established procedure used to decompress the optic nerve, mobilize the internal carotid artery (ICA), or enlarge the retrocarotid space. However, its use carries the risk of optic nerve injury. In certain surgeries, such as those for internal carotid aneurysm...

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Main Authors: Toshikazu Kimura, Yasuhiro Takeda, Shunsuke Ichi
Format: Article
Language:English
Published: Elsevier 2023-04-01
Series:World Neurosurgery: X
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2590139723000030
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author Toshikazu Kimura
Yasuhiro Takeda
Shunsuke Ichi
author_facet Toshikazu Kimura
Yasuhiro Takeda
Shunsuke Ichi
author_sort Toshikazu Kimura
collection DOAJ
description Background: Anterior clinoidectomy is an established procedure used to decompress the optic nerve, mobilize the internal carotid artery (ICA), or enlarge the retrocarotid space. However, its use carries the risk of optic nerve injury. In certain surgeries, such as those for internal carotid aneurysms, propose modification to the anterior clinoidectomy for enlarging the retrocarotid space, especially in operations for ICA aneurysms. Methods: After the anterior clinoid process (ACP) is sufficiently exposed, the internal cancellous bone or pneumatization can be removed through a small window created at its lateral edge to reveal the compact bone of the optic canal. Since the compact bone of the inferior surface facing the ICA is absent or very thin, the ACP can be removed by drilling through the anchoring compact bone with the optic canal in direct sight. Results: In 10 consecutive internal carotid aneurysm cases, the ACP was successfully removed without opening of the optic canal to enlarge the retrocarotid space. Conclusions: Anterior clinoidectomy can be performed to enlarge the retrocarotid space without opening the optic canal from outside the dura.
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spelling doaj.art-1d5f8e3921014d58b53beeef507e15bd2023-04-09T05:49:46ZengElsevierWorld Neurosurgery: X2590-13972023-04-0118100154Modified extradural selective anterior clinoidectomy leaving the optic canal unopened for internal carotid aneurysms: A technical noteToshikazu Kimura0Yasuhiro Takeda1Shunsuke Ichi2Corresponding author. Department of Neurosurgery, Japanese Red Cross Medical Center 4-1-22 Hiroo, Shibuya City, Tokyo 150-8935, Japan.; Department of Neurosurgery, Japanese Red Cross Medical Center, Tokyo, JapanDepartment of Neurosurgery, Japanese Red Cross Medical Center, Tokyo, JapanDepartment of Neurosurgery, Japanese Red Cross Medical Center, Tokyo, JapanBackground: Anterior clinoidectomy is an established procedure used to decompress the optic nerve, mobilize the internal carotid artery (ICA), or enlarge the retrocarotid space. However, its use carries the risk of optic nerve injury. In certain surgeries, such as those for internal carotid aneurysms, propose modification to the anterior clinoidectomy for enlarging the retrocarotid space, especially in operations for ICA aneurysms. Methods: After the anterior clinoid process (ACP) is sufficiently exposed, the internal cancellous bone or pneumatization can be removed through a small window created at its lateral edge to reveal the compact bone of the optic canal. Since the compact bone of the inferior surface facing the ICA is absent or very thin, the ACP can be removed by drilling through the anchoring compact bone with the optic canal in direct sight. Results: In 10 consecutive internal carotid aneurysm cases, the ACP was successfully removed without opening of the optic canal to enlarge the retrocarotid space. Conclusions: Anterior clinoidectomy can be performed to enlarge the retrocarotid space without opening the optic canal from outside the dura.http://www.sciencedirect.com/science/article/pii/S2590139723000030Anterior clinoidectomyInternal carotid artery aneurysmOptic canalAnterior clinoid process
spellingShingle Toshikazu Kimura
Yasuhiro Takeda
Shunsuke Ichi
Modified extradural selective anterior clinoidectomy leaving the optic canal unopened for internal carotid aneurysms: A technical note
World Neurosurgery: X
Anterior clinoidectomy
Internal carotid artery aneurysm
Optic canal
Anterior clinoid process
title Modified extradural selective anterior clinoidectomy leaving the optic canal unopened for internal carotid aneurysms: A technical note
title_full Modified extradural selective anterior clinoidectomy leaving the optic canal unopened for internal carotid aneurysms: A technical note
title_fullStr Modified extradural selective anterior clinoidectomy leaving the optic canal unopened for internal carotid aneurysms: A technical note
title_full_unstemmed Modified extradural selective anterior clinoidectomy leaving the optic canal unopened for internal carotid aneurysms: A technical note
title_short Modified extradural selective anterior clinoidectomy leaving the optic canal unopened for internal carotid aneurysms: A technical note
title_sort modified extradural selective anterior clinoidectomy leaving the optic canal unopened for internal carotid aneurysms a technical note
topic Anterior clinoidectomy
Internal carotid artery aneurysm
Optic canal
Anterior clinoid process
url http://www.sciencedirect.com/science/article/pii/S2590139723000030
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