| OPERATIVE NUANCES: STEP BY STEP (VIDEO SECTION)
|Year : 2022 | Volume
| Issue : 2 | Page : 504--509
Hybrid Anterior Clinoidectomy in the Clipping of Paraclinoid Aneurysms: Technique, Utility and Case Illustration
Kuntal Kanti Das, Arun Kumar Srivastava, Kamlesh Singh Bhaisora, Balachandar, Awadhesh Kumar Jaiswal, Sanjay Behari
Department of Neurosurgery, SGPGIMS, Lucknow, Uttar Pradesh, India
Background: Anterior clinoidectomy for aneurysm clipping is generally performed intradurally. Despite obvious advantages, accidental drill slippage or indirect damage from heat and bone dust remain major drawbacks.
Objective: To demonstrate the surgical technique and utility of a combined extra- and intra-dural clinoidectomy in the clipping of dorsal wall paraclinoid internal carotid artery aneurysm.
Material and Methods: A case of dorsal wall paraclinoid aneurysm which was stuck to the anterior clinoid process on preoperative angiogram is presented. The surgical technique is shown stepwise, and the intricacies of the technique are described.
Results: The hybrid clinoidectomy allowed for proper delineation of the aneurysm, mobilization of the optic nerve and intracranial proximal control on the clinoidal segment by dint of “apparent” intracranial ICA lengthening. This allowed the aneurysm to be clipped successfully and the patient made an uneventful recovery.
Conclusion: Hybrid clinoidectomy is a useful technique and must be learnt.
Dr. Kuntal Kanti Das
Department of Neurosurgery, SGPGIMS, Lucknow - 226 014, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
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