title: Extradural anterior clinoidectomy. Technical note.
abstract: The anterior clinoid process (ACP), located on the skull base, is a relatively small structure, although its removal provides enormous gain in facilitating the management of lesions--either tumors or aneurysms--in the paraclinoid region and upper basilar artery. The extensive surgical field gained contributes to safer exposure of the neurovascular elements in the vicinity while avoiding excessive and hazardous retraction of the brain. In this report the authors present a technically simpler avenue for performing an extradural anterior clinoidectomy after reviewing the anatomy of the ACP and its anatomical variations. Additionally, the original Dolenc procedure and its subseqtient derivatives are compared and contrasted to the authors' simpler and less laborious technique. Different clinical situations in which to use the procedure are described based on the authors' experience from 60 cases (40 aneurysm cases and 20 tumor cases) during a 4-year period.
authors.affiliation: Division of Skull Base Neurosurgery, Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon 97239, USA.
authors.forename: Akio
authors.initials: A
authors.lastname: Noguchi
authors.forename: Vijayabalan
authors.initials: V
authors.lastname: Balasingam
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Shiokawa
authors.forename: Sean O
authors.initials: SO
authors.lastname: McMenomey
authors.forename: Johnny B
authors.initials: JB
authors.lastname: Delashaw
mesh_terms: D001932:Brain Neoplasms / Q000601:surgery; D003399:Craniotomy / Q000379:methods; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery; D019291:Skull Base / Q000033:anatomy & histology / Q000601:surgery*