Department of Neurosurgery, SGPGIMS, Lucknow, Uttar Pradesh, India.
Neurol India. 2022 Mar-Apr;70(2):504-509. doi: 10.4103/0028-3886.344615.
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.
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.
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.
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.
Hybrid clinoidectomy is a useful technique and must be learnt.
前床突切除术通常在硬脑膜内进行用于夹闭动脉瘤。尽管有明显的优势，但钻头意外滑动或热和骨屑的间接损伤仍然是主要的缺点。
展示一种联合硬膜内外床突切除术在夹闭颅底外侧颈内动脉动脉瘤中的手术技术和实用性。
报告一例术前血管造影显示位于前床突上的颅底外侧壁动脉瘤。逐步展示手术技术，并描述技术的复杂性。
杂交床突切除术通过“明显”的颅内颈内动脉延长，允许对动脉瘤进行适当的描绘，视神经的移动和颅内侧近端控制。这使得成功夹闭动脉瘤，患者恢复顺利。
杂交床突切除术是一种有用的技术，必须学习。
