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Pterional approach

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https://www.readbyqxmd.com/read/28780846/-clinical-analysis-of-lateral-supraorbital-microsurgical-approach-for-ruptured-anterior-circulation-aneurysm
#1
Q H Meng, J J Xu, S C Wei, R Yu, J Jiang, J Wang, C C Qu
Objective: To explore the safety and efficiency of lateral supraorbital (LSO) approach for the ruptured anterior circulation aneurysm. Methods: The clinical data of 23 patients with grade Ⅰ-Ⅲ ruptured anterior circulation aneurysm via LSO at the Second Hospital of Shandong University from February 2016 to December 2016 were retrospectively analyzed. The clinical data included their clinical manifestations, radiological finding, microsurgical techniques and follow-up results. Results: All patients were diagnosed as anterior circulation aneurysm by preoperative CT angiography (CTA) or Digital Subtraction Angiography (DSA)...
August 1, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28761525/the-minipterional-approach-for-ruptured-and-unruptured-anterior-circulation-aneurysms-our-initial-experience
#2
Kenan A Alkhalili, Jack R Hannallah, Gasser H Alshyal, Mohab M Nageeb, Khaled M Abdel Aziz
OBJECTIVE: To report our experience with the minipterional (MPT) craniotomy approach for anterior circulation aneurysms and to discuss the clinical outcomes as well as to evaluate the advantages of this unique approach. MATERIALS AND METHODS: Single-center retrospective review of 57 cases involving anterior circulation aneurysms both ruptured and unruptured aneurysms treated with the MPT. We analyzed the clinical and patient demographic data, aneurysm characteristics, surgical outcomes, and complications in these individuals...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28705701/piezosurgery-in-modified-pterional-orbital-decompression-surgery-in-graves-disease
#3
Juergen Grauvogel, Christian Scheiwe, Waseem Masalha, Nadja Jarc, Tanja Grauvogel, Andreas Beringer
OBJECTIVE: Piezosurgery utilizes microvibrations to selectively cut bone, preserving the adjacent soft tissue. The present study evaluated the use of piezosurgery for bone removal in orbital decompression surgery in Graves' disease via a modified pterional approach. METHODS: A piezosurgical device (Piezosurgery medical®) was used in 14 patients (20 orbits) with Graves' disease who underwent orbital decompression surgery in additional to drills and rongeurs for bone removal of the lateral orbital wall and orbital roof...
July 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28646464/early-retreatment-after-surgical-clipping-of-ruptured-intracranial-aneurysms
#4
Yoshiro Ito, Tetsuya Yamamoto, Go Ikeda, Wataro Tsuruta, Kazuya Uemura, Yoji Komatsu, Akira Matsumura
BACKGROUND: Although a rerupture after surgical clipping of ruptured intracranial aneurysms is rare, it is associated with high morbidity and mortality. The causes for retreatment and rupture after surgical clipping are not clearly defined. METHODS: From a prospectively maintained database of 244 patients who had undergone surgical clipping of ruptured intracranial aneurysms, we selected patients who experienced retreatment or rerupture within 30 days after surgical clipping...
June 23, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28602922/the-spheno-pterional-point-a-strategic-point-for-burr-role-placement-in-frontotemporal-craniotomies
#5
Baltazar Leão Reis, Roberto Leal da Silveira, Sebastião Nataniel Silva Gusmão
BACKGROUND: Frontotemporal craniotomies are the most commonly performed neurosurgical approaches. We studied the external bony landmarks on the lateral surface of the skull to identify a "strategic" point where both the anterior and middle cranial fossae are exposed simultaneously during frontotemporal craniotomies through a single burr hole placed over the greater wing of sphenoid bone (spheno-pterional point). OBJECTIVE: This study aimed to anatomically define the spheno-pterional point via craniometric measurements taken on the lateral surface of the human skull...
June 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28576712/preserving-the-facial-nerve-during-the-orbitozygomatic-craniotomy-surgical-anatomy-assessment-and-stepwise-illustration
#6
Ali Tayebi Meybodi, Michael T Lawton, Sonia Yousef, Jj González Sánchez, Arnau Benet
OBJECTIVE: Surgical safety and efficiency during an OZ osteotomy rely on thorough knowledge of the surgical anatomy of the facial nerve. Although the anatomy of the facial nerve and its relation to the pterional craniotomy are described, a thorough assessment of facial nerve preservation techniques during the OZ approach and its variations is lacking. We assessed the surgical anatomy of the facial nerve related to the OZ and provided a thorough stepwise description on how to preserve it...
May 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28499903/use-of-paine-s-technique-projecting-puncture-point-to-the-skull-and-skin
#7
Hiroaki Matsuzaki, Tadahiro Otsuka, Ken Uekawa, Takashi Nakagawa, Nobuyuki Tsubota
OBJECTIVE: Ventriculostomy from Paine's point is an effective technique to ensure that the brain is relaxed for aneurysm surgery. This study aimed to use Paine's point for other neurosurgical procedures (except for those that require a pterional approach) by delineation of surface landmarks for identification of Paine's point on the cranium and scalp. METHODS: Based on the anatomical knowledge and examination of 3-dimensional computed tomography images of skull, we determined novel surface landmarks to identify Paine's point on the cranium and scalp...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28490152/keyhole-approach-and-neuroendoscopy-for-cerebral-aneurysms
#8
REVIEW
Won-Sang Cho, Jeong Eun Kim, Hyun-Seung Kang, Young-Je Son, Jae Seung Bang, Chang Wan Oh
Treating diseases in the field of neurosurgery has progressed concomitantly with technical advances. Here, as a surgical armamentarium for the treatment of cerebral aneurysms, the history and present status of the keyhole approach and the use of neuroendoscopy are reviewed, including our clinical data. The major significance of keyhole approach is to expose an essential space toward a target, and to minimize brain exposure and retraction. Among several kinds of keyhole approaches, representative keyhole approaches for anterior circulation aneurysms include superciliary and lateral supraorbital, frontolateral, mini-pterional and mini-interhemispheric approaches...
May 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28484528/extradural-anterior-clinoidectomy-technical-nuances-from-a-learner-s-perspective
#9
Shashwat Mishra, Baltazar Leão, Diego Mendez Rosito
BACKGROUND: Extradural removal of the anterior clinoid process (ACP) is a crucial step in the proper surgical exposure of various pathologies in and around the central skull base. Since the pioneering description by Dolenc, the technique of extradural clinoidectomy has undergone several refinements in the light of improved understanding of microsurgical anatomy and maturation of neurosurgical techniques. Mastery of the surgical nuances involved in performing this surgical exercise will allow the young neurosurgeon to execute this step without undue reluctance and trepidation...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28479524/efficacy-of-arachnoid-plasty-on-chronic-subdural-hematoma-following-surgical-clipping-of-unruptured-intracranial-aneurysms
#10
Jae-Hyun Kim, Chang-Hyun Kim, Chang-Young Lee
BACKGROUND: We aimed to elucidate the effects of arachnoid plasty (ARP) on chronic subdural hematoma (CSDH) occurrence following clipping surgery. METHODS: In total 217 patients (ARP, n = 97; non-ARP, n = 120) who had undergone unruptured intracranial aneurysm (UIA) surgical clipping via the pterional approach were retrospectively assessed. Predisposing factors for CSDH development following the surgery were investigated. Thickness and volume of the subdural fluid collection (SDFC) were measured to determine whether ARP affects postoperative SDFC...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28403097/predictive-factors-for-surgical-outcome-in-anterior-clinoidal-meningiomas-analysis-of-59-consecutive-surgically-treated-cases
#11
Ju-Hwi Kim, Woo-Youl Jang, Tae-Young Jung, In-Young Kim, Kyung-Hwa Lee, Woo Dae Kang, Seul-Kee Kim, Kyung-Sub Moon, Shin Jung
Despite the advances in the microsurgical technique and anatomical understanding of the anterior and middle skull base, anterior clinoidal meningiomas are still challenging lesions to resect completely and safely due to their intimate relationship with vital neurovascular structures. We report predictive factors for tumor recurrence and postoperative complications based on surgical outcome of patients with anterior clinoidal meningiomas treated at our institution.Fifty-nine consecutive patients with anterior clinoidal meningioma who were surgically treated between March, 1993, and July, 2015, were reviewed retrospectively...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28291217/-early-postoperative-results-of-surgical-treatment-of-patients-with-anterior-clinoidal-meningiomas
#12
S V Chernov, D A Rzaev, A V Kalinovsky, A B Dmitriev, A R Kasymov, A V Zotov, E V Gormolysova, E K Uzhakova
Resection of anterior clinoidal meningiomas is a challenging task due to their localization, frequent involvement of the major cerebral arteries and cranial nerves, a high risk of postoperative neurological deficits, and low radicalness of surgery. AIM: To evaluate the radicalness of microsurgical removal and a neurological deficit in the early postoperative period in patients with anterior clinoidal meningiomas. MATERIAL AND METHODS: A total of 35 patients with anterior clinoidal meningiomas underwent surgery at the Department of Neurooncology of the Novosibirsk Federal Neurosurgical Center in the period from 2013 to July 2016...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28264247/pterional-or-subfrontal-access-for-proximal-vascular-control-in-anterior-interhemispheric-approach-for-ruptured-pericallosal-artery-aneurysms-at-risk-of-premature-rupture
#13
Jaechan Park
OBJECTIVE: Cases of a ruptured pericallosal artery aneurysm with a high risk of intraoperative premature rupture and technical difficulties for proximal vascular control require a technique for the early and safe establishment of proximal vascular control. METHODS: A combined pterional or subfrontal approach exposes the bilateral A1 segments or the origin of the ipsilateral A2 segment of the anterior cerebral artery (ACA) for proximal vascular control. Proximal control far from the ruptured aneurysm facilitates tentative clipping of the rupture point of the aneurysm without a catastrophic premature rupture...
March 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28254603/outcome-of-radical-surgical-resection-for-craniopharyngioma-with-hypothalamic-preservation-a-single-center-retrospective-study-of-1054-patients
#14
Xiang'en Shi, Zhongqing Zhou, Bin Wu, Yongli Zhang, Hai Qian, Yuming Sun, Yang Yang, Zaitao Yu, Zhiwei Tang, Shuaibin Lu
OBJECTIVE: A retrospective review of the surgical outcome for patients with craniopharyngioma (CP) treated in a single neurosurgical center with surgical resection using visualization to ensure hypothalamic preservation. METHODS: The study included 1054 patients. Before 2003, a pterional cranial approach was preferred for 78% of patients; after 2004, the unifrontal basal interhemispheric approach was performed in 79.1% of patients. RESULTS: Complete tumor resection was achieved in 89...
June 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28254536/quantification-of-working-volumes-exposure-and-target-specific-maneuverability-of-the-pterional-craniotomy-and-its-minimally-invasive-variants
#15
Max Jägersberg, Jerermy Brodard, Jimmy Qiu, Alireza Mansouri, Francesco Doglietto, Fred Gentili, Walter Kucharczyk, Jean Fasel, Karl Schaller, Ivan Radovanovic
OBJECTIVE: Quantitative comparison of minimally invasive and standard cranial approaches remains a methodologic challenge. The aim of this study was to apply a new digital, navigation-based method to quantify multiple parameters of the pterional, supraorbital, lateral supraorbital and mini-pterional approaches and to describe a target-specific maneuverability score. METHODS: Supraorbital, lateral supraorbital, mini-pterional, and standard pterional craniotomies were performed on 8 sides in 4 cadaver heads...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28254535/keyhole-approach-for-clipping-intracranial-aneurysm-comparison-of-supraorbital-and-pterional-keyhole-approach
#16
Qing Lan, Hengzhu Zhang, Qing Zhu, Ailin Chen, Yanming Chen, Liang Xu, Zhongyong Wang, Liqun Yuan, Shihai Liu
OBJECTIVE: The aim of this research was to compare the functional outcome and safety between supraorbital keyhole approach (SKA) and pterional keyhole approach (PKA) for clipping intracranial aneurysms. METHODS: This is a retrospective study involving 318 patients with a total of 365 aneurysms who underwent keyhole surgery, comprising 195 cases in SKA group and 123 cases in PKA group. The outcome measures include Glasgow Outcome Scale, complete clipping rate, adverse events incidence, operation view angle, working distance, and surgical incision condition...
June 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28217394/technical-nuances-of-subtemporal-approach-for-the-treatment-of-basilar-tip-aneurysm
#17
Vladimir S Nakov, Toma Y Spiriev, Ivan T Todorov, Plamen Simeonov
BACKGROUND: Basilar tip aneurysms are one of the most complex vascular lesions to treat surgically because of their location, depth of the approach, and close proximity of vital neurovascular structures such as the mesencephalon, cranial nerves, perforating arteries to the thalamus. There are different surgical approaches utilized to reach basilar tip aneurysms, namely, pterional, pretemporal, orbitozygomatic, subtemporal, and anterior petrosectomy. Each of them has its advantages and limitations...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28216398/engaging-in-a-keyhole-concept-for-the-management-of-ruptured-and-unruptured-aneurysms
#18
Daniel D Cavalcanti, Roberto C de Paula, Paula L Alvarenga, Paulo José da Mata Pereira, Paulo Niemeyer Filho
OBJECTIVE: Many new endovascular devices have been used under the guidance of the International Subarachnoid Aneurysm Trial. Clipping still offers higher occlusion rates, and its technique continues to evolve, resulting in smaller exposures and reduced manipulation to brain tissue. We sought to evaluate the routine use of the minisphenoidal approach to manage intracranial aneurysms in a high-volume institution. METHODS: We retrospectively reviewed our database of patients with aneurysm from October 2013 to May 2016...
June 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28197790/surgical-treatment-of-anterior-cranial-fossa-dural-arterio-venous-fistulas-davfs-a-two-centre-experience
#19
Pietro Meneghelli, Alberto Pasqualin, Luigi Andrea Lanterna, Claudio Bernucci, Roberto Spinelli, Gianluigi Dorelli, Piergiuseppe Zampieri
BACKGROUND: Anterior cranial fossa dural arterio-venous fistulas (DAVFs) represent 6% of all intracranial DAVFs; characteristically they show an aggressive behaviour with high risk of intracranial haemorrhage. Peculiar anatomical features, such as feeding by the ethmoidal arteries and the pattern of venous drainage (frequently with varices that mimic aneurysmal dilatation), can be evaluated in detail only by digital subtraction angiography (DSA), which represents the "gold standard" in the diagnosis of such cranial fistulas...
May 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28120059/minipterional-craniotomy-for-treatment-of-unruptured-middle-cerebral-artery-aneurysms-a-single-center-comparative-analysis-with-standard-pterional-approach-as-regard-to-safety-and-efficacy-of-aneurysm-clipping-and-the-advantages-of-reconstruction
#20
Carmelo Lucio Sturiale, Giuseppe La Rocca, Alfredo Puca, Eduardo Fernandez, Massimiliano Visocchi, Enrico Marchese, Giovanni Sabatino, Alessio Albanese
Pterional craniotomy (PT) has long been the standard approach for the treatment of middle cerebral artery (MCA) aneurysms, even though it may cause temporalis muscle atrophy, facial nerve injury, and masticatory difficulties. Minipterional craniotomy (MPT) is an alternative approach that may provide the same surgical corridor, limiting the risk of postoperative esthetic and functional complications. From January 2011 to December 2014 we consecutively performed 68 craniotomies for surgical treatment of unruptured MCA aneuryms: 37 were standard PT and 31 were MPT...
2017: Acta Neurochirurgica. Supplement
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