Cardboard dural retractor for drilling of the sphenoid wing in the pterional approach.

Background: In the pterional approach, adequate removal of the sphenoid wing is essential. For safe drilling of the medial part, the dura beside the wing is usually retracted with a metal instrument and damage to the instrument may occur. We developed an alternative retraction method that uses a cardboard shield.

Methods: Before drilling the medial part of the sphenoid wing, a cardboard shield featuring a notch and a bend in its center is prepared. The notch is inserted between the wing to be drilled and the dura.

Results: The shield retracted the dura beside the wing effectively and provided sufficient space for the diamond drill bit. It held up to the drilling and protected the dura.

Conclusion: This simple method provides a safe adequate operative field without involving additional instruments or expenditures.