我是这样做的：使用逆行抽吸减压技术对巨大翼突旁动脉瘤进行显微夹闭。
How I do it: The microsurgical clipping of the giant paraclinoid aneurysm using the retrograde suction decompression technique.
机构信息
MONIKI M. F. Vladimirskii Moscow Regional Scientific Research Institute, Moscow, Russia.
Federal State Budgetary Educational Institution of Further Professional Education "Russian Medical Academy of Continuous Professional Education", Moscow, Russia.
出版信息
Acta Neurochir (Wien). 2023 Apr;165(4):1021-1026. doi: 10.1007/s00701-023-05525-6. Epub 2023 Feb 16.
BACKGROUND
Paraclinoid aneurysms account for 5.4% of all intracranial aneurysms. Giant aneurysms are found in 49% of these cases. The 5-year cumulative rupture risk is 40%. Microsurgical treatment of paraclinoid aneurysms is a complex challenge that requires a personalized approach.
METHOD
Extradural anterior clinoidectomy and optic canal unroofing were performed in addition to orbitopterional craniotomy. Falciform ligament and distal dural ring transection provided the internal carotid artery and optic nerve mobilization. Retrograde suction decompression was used to soften the aneurysm. Clip reconstruction was performed using tandem angled fenestration and parallel clipping techniques.
CONCLUSION
Orbitopterional approach with extradural anterior clinoidectomy combined with retrograde suction decompression technique is a safe and effective modality for treatment of giant paraclinoid aneurysms.
背景
颅眶沟通瘤占所有颅内动脉瘤的 5.4%。其中 49%为巨大动脉瘤。5 年累积破裂风险为 40%。颅眶沟通瘤的显微外科治疗是一项复杂的挑战，需要个性化的治疗方法。
方法
在眶颧开颅术的基础上进行硬膜外前床突切除术和视神经管减压术。镰状韧带和远端硬脑膜环横断术为颈内动脉和视神经的牵开提供了便利。逆行抽吸减压用于软化动脉瘤。采用串联成角开窗和平行夹闭技术进行夹闭重建。
结论
经硬膜外前床突切除术联合逆行抽吸减压技术的眶颧入路是治疗巨大颅眶沟通瘤的一种安全有效的方法。
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