Supraorbital Approach for Resection of Clinoidal Meningioma.

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Supraorbital Approach for Resection of Clinoidal Meningioma.

World Neurosurg. 2017 Oct 13;:

Authors: Dossani RH, Kalakoti P, Guthikonda B

Abstract
Meningiomas of the clinoid region pose formidable surgical challenge. Pterional craniotomy is the traditional approach, and often associated with high-risk post-surgical morbidities. In the current presentation, we describe an elderly male with a clinoidal meningioma that underwent a minimally invasive supra-orbital craniotomy for tumor resection. Patient presentation, neuroimaging, and surgical techniques (patient position, incision, anatomical consideration, and surgical steps) are described meticulously. Initial intraoperative steps include dissection via the corridor between the carotid artery and the tentorium, and exposing the tumor in the optico-carotid triangle, followed by tumor dissection using microsurgical techniques. Care must be taken to preserve the supraorbital nerve to prevent frontal numbness, and to avoid violation of the frontal sinus to prevent postoperative cerebrospinal fluid leak. Emphasis on using this minimally invasive procedure for clinoidal meningiomas over pterional approach for select cohort of patients is laid, considering the cosmetic merits and adequate extent of tumor resection.

PMID: 29038082 [PubMed - as supplied by publisher]

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