title: Cranio-orbito-zygomatic approach for a previously coiled/recurrent giant MCA aneurysm in a hybrid angio/OR suite.
abstract: We present surgical clipping of a giant middle cerebral artery aneurysm. The patient is a 64-year-old woman who suffered subarachnoid hemorrhage in 2005. She was treated with coiling of the aneurysm at an outside institution. She presented to our clinic with headaches and was found on angiography to have giant recurrence of the aneurysm. To allow adequate exposure for clipping, we performed the surgery through a cranio-orbito-zygomatic (COZ) skull base approach, which is demonstrated. The surgery was performed in an operating room/angiography hybrid suite allowing for high quality intraoperative angiography. The technique and room flow are also demonstrated. The video can be found here: http://youtu.be/eePcyOMi85M.
authors.affiliation: Department of Neurosurgery, Temple University Hospital;
authors.forename: Leopold
authors.initials: L
authors.lastname: Arko
authors.affiliation: Temple University School of Medicine, Philadelphia, Pennsylvania; and.
authors.forename: Eric
authors.initials: E
authors.lastname: Quach
authors.affiliation: Department of Neurosurgery, Temple University Hospital;
authors.forename: Vishad
authors.initials: V
authors.lastname: Sukul
authors.affiliation: Temple University School of Medicine, Philadelphia, Pennsylvania; and.
authors.forename: Anuj
authors.initials: A
authors.lastname: Desai
authors.affiliation: Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee.
authors.forename: Kelly
authors.initials: K
authors.lastname: Gassie
authors.affiliation: Department of Neurosurgery, Temple University Hospital;|Temple University School of Medicine, Philadelphia, Pennsylvania; and.
authors.forename: Kadir
authors.initials: K
authors.lastname: Erkmen
mesh_terms: D002533:Cerebral Angiography; D005260:Female; D005624:Frontal Bone / Q000601:surgery; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D019291:Skull Base / Q000601:surgery*; D013525:Surgical Instruments; D013701:Temporal Bone / Q000601:surgery; D015050:Zygoma / Q000601:surgery
keywords: COZ; cranio-orbito-zygomatic approach; hybrid angiography; skull base approach; video