Protective dural flap for bone drilling at the paraclinoid region and porus acusticus--technical note.
A new method was developed to avoid the risk of injury to the cranial nerves and vessels during intradural bone resection at the paraclinoid region and porus acusticus. The semicircular dural flap is pulled out with a thread over the anterior clinoid process or the porus acusticus. The flap is extended over the underlying structures with a tapered spatula to create adequate space for drilling the bone. The site for drilling was adequately exposed and bone was drilled away smoothly without damaging the underlying vessels and nerves in 10 patients with paraclinoid aneurysms and in seven patients with vestibular schwannomas. This "protective dural flap" method provides wide exposure for drilling, protects the underlying structures, and allows quick inspection during bone resection.
Tanaka
Yuichiro
Y
Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan. tanaka@hsp.md.shinshu-u.ac.jp
Hongo
Kazuhiro
K
Tada
Tsuyoshi
T
Kakizawa
Yukinari
Y
Kobayashi
Shigeaki
S
D001927:Brain Diseases / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D004388:Dura Mater / Q000601:surgery*; D006801:Humans; D013100:Sphenoid Bone / Q000601:surgery*; D013524:Surgical Flaps