Modified Extradural Temporopolar Approach for Paraclinoid Aneurysms: Operative Nuance and Surgical Result.

BACKGROUND: Extradural temporopolar approach can provide extensive exposure of the anterior clinoid process, which can prevent intraoperative neurovascular injury in anterior clinoidectomy for paraclinoid aneurysms. The present study investigates the usefulness of this modified technique, and operative nuances are discussed here.

METHODS: We retrospectively reviewed the medical charts of 30 consecutive patients with paraclinoid aneurysms who underwent treatment with this modified extradural temporopolar approach between September 2009 and March 2016.

RESULTS: Worsening of visual acuity was documented postoperatively in three patients (10.0%), and visual field function worsened in three patients (10.0%). Postoperative outcome was good recovery in all patients. No operation-related mortality occurred in the series.

CONCLUSION: Extradural anterior clinoidectomy via the modified extradural temporopolar approach is safe and may be recommended for surgical treatment of paraclinoid aneurysms to reduce the risk of intraoperative optic neurovascular injury.