title: Orbital apex osteodural fistula--An unusual surgical access.
abstract: Dural arteriovenous fistulas (DAVFs) are fistulas connecting the branches of dural arteries to dural veins or a venous sinus. Osteodural fistulas are a rare subset of this group of diseases. We wish to report a rare case of an osteodural arteriovenous fistula at the foot of the superior ophthalmic vein (SOV), treatment of which required an unusual surgical approach via the orbit and SOV. Though access for endovascular treatment via the SOV for treatment of caroticocavernous fistulas is reported, the external approach is relatively infrequently performed, outside Europe and the Americas, with this being the first reported procedure from the Indian subcontinent. We wish to explain the steps of this unusual surgical access and highlight the salient precautions and pitfalls in the technique.
authors.affiliation: Department of Ophthalmology, Indian Naval Hospital Ship Asvini, Mumbai, Maharashtra, India.
authors.forename: Hemant
authors.initials: H
authors.lastname: Trehan
authors.forename: Rajeev
authors.initials: R
authors.lastname: Sivasankar
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Agrawal
authors.forename: Merlin
authors.initials: M
authors.lastname: Saldanha
authors.forename: Nikita
authors.initials: N
authors.lastname: Sonawane
authors.forename: Rochan
authors.initials: R
authors.lastname: Pant
authors.forename: Shreyansh
authors.initials: S
authors.lastname: Doshi
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction; D002426:Cavernous Sinus / Q000000981:diagnostic imaging*; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009915:Orbit / Q000098:blood supply*