Pterional Approach : How to avoid Complications(<SPECIAL ISSUE>Selection of Surgical Approach and Pitfall I)

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  • Tanaka Yuichiro
    Department of Neurosurgery, St. Marianna University School of Medicine
  • Kohno Takao
    Department of Neurosurgery, St. Marianna University School of Medicine
  • Uchida Masashi
    Department of Neurosurgery, St. Marianna University School of Medicine
  • Kosuge Yasushi
    Department of Neurosurgery, St. Marianna University School of Medicine
  • Onodera Hidetaka
    Department of Neurosurgery, St. Marianna University School of Medicine
  • Endou Shu
    Department of Neurosurgery, St. Marianna University School of Medicine
  • Yoshida Yasuyuki
    Department of Neurosurgery, St. Marianna University School of Medicine
  • Ito Hidemichi
    Department of Neurosurgery, St. Marianna University School of Medicine
  • Hiramoto Jun
    Department of Neurosurgery, St. Marianna University School of Medicine
  • Morishima Hiroyuki
    Department of Neurosurgery, St. Marianna University School of Medicine
  • Sakakibara Yohtaro
    Department of Neurosurgery, St. Marianna University School of Medicine
  • Hashimoto Takuo
    Department of Neurosurgery, St. Marianna University School of Medicine

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  • Pterional approach(蝶形骨縁到達法) : ピットフォール回避の知識(<特集>手術アプローチの選択とピットフォールI-第24回微小脳神経外科解剖セミナーより-)

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The pterional approach is arguably the most popular surgical approach for neurosurgeons. Therefore, we should understand and experience this approach properly. The other surgical approaches can be learned readily once this approach is mastered. The principle aspect of the pterional approach is an appropriate exposure of the parasellar area without damaging the brain and vessels. There are various surgical options based on the primary disease and patterns of the sylvian veins. We will discuss about methods for widening the pterional approach, including manipulation of the sylvian vein and sphenoparietal sinus, the temporopolar approach, optic unroofing, anterior clinoidectomy, resection of the tuberculum sellae, and section of the dural ring.

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