Trans-superior Orbital Fissure Extradural Anterior Clinoidectomy based on Three-dimensional Skull Base Model(SURGICAL TECHNIQUES and PERIOPERATIVE MANAGEMENT)

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  • Mori Kentaro
    Department of Neurosurgery, Juntendo University Shizuoka Hospital
  • Yamamoto Takuji
    Department of Neurosurgery, Juntendo University Shizuoka Hospital
  • Nakao Yasuaki
    Department of Neurosurgery, Juntendo University Shizuoka Hospital
  • Esaki Takanori
    Department of Neurosurgery, Juntendo University Shizuoka Hospital

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  • 経上眼窩裂硬膜外前床突起切除術 : 3次元立体頭蓋底モデルを用いた解説を中心に(手術手技・周術期管理)

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Removal of the anterior clinoid process (ACP) is an essential technique in skull base surgery. The trans-superior orbital fissure (SOF) extradural anterior clinoidectomy (trans-SOF method) is a recently developed method involving resection of the meningo-orbital band, peeling the dura propria from the SOF, exposing the entire ACP, and drilling away the ACP. If cutting the medial tentorial edge is added after the trans-SOF method, we can transpose to the extradural temporopolar trans-cavernous approach. We illustrate this method using the three-dimensional skull base model with artificial cavernous sinus and intraoperative photographs. We performed the trans-SOF method in the 21 patient. The incidences of postoperative visual acuity (5%) and field disturbance (10%) were relatively low. The trans-SOF method is safe to remove the ACP under direct operative view and can be transposed to the trans-cavernous approach if necessary.

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