One of the significant events in aneurysm surgery was promotion of a microneurosurgical technique by G. Yasargil. Despite its versatility, pterional craniotomy is associated with extensive osteotomy and a significant incision of the skin and temporal muscle, which may lead to the adverse cosmetic effects, risk of temporomandibular joint dysfunction, injury to the frontal branch of the facial nerve, and facial and scalp numbness. We present our experience with minipterional craniotomy in surgery for anterior circle of Willis aneurysms in 40 patients. There were no serious complications or deaths. Also, there were no intraoperative aneurysm ruptures. All patients had expected transient hypesthesia in the temporal region, which was not considered as a complication. This region was significantly smaller compared to that in classical pterional craniotomy. Patients assessed the postoperative cosmetic outcome as excellent.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.17116/neiro201680658-65 | DOI Listing |
Neurosurg Rev
January 2025
Division of Neurosurgery, Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
The mini-pterional craniotomy (mPT) was designed to be a minimally invasive alternative to the standard pterional (PT) approach. However, it remains unclear which technique produces better results. Thus, we aimed to perform a meta-analysis comparing functional, surgical, and aesthetic outcomes between mPT and PT in intracranial aneurysms.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
October 2024
Department of Cerebrovascular and Skull Base Surgery, Instituto de Neurocirugía Dr. Alfonso Asenjo, Santiago, Chile.
Neurol India
September 2024
Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Surg Neurol Int
August 2024
Department of Neurosurgery, University of Sao Paulo, Facultade das Clinicas, Sao Paulo, Brazil.
Background: The pterional craniotomy, described by Yasargil and Fox in 1975, constitutes the most traditional and important surgical access in vascular neurosurgery. Minimally invasive alternatives include the minipterional (MP) and lateral supraorbital (LSO) craniotomies, which avoid complications such as injury to the frontal branch of the facial nerve, temporal muscle dysfunction, depression of the craniotomy site, frontal sinus opening, and cosmetically unacceptable outcomes. We evaluated and compared the exposures provided by MP and LSO craniotomies through quantitative measurements of the surgical exposure area around the circle of Willis and parasellar regions, as well as angular and linear exposures of the internal carotid artery (ICA) bifurcation, middle cerebral artery (MCA), midpoint of the anterior communicating artery, and tip of the basilar artery (BA).
View Article and Find Full Text PDFNeurosurg Rev
July 2024
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 2910 North Third Avenue, Phoenix, AZ, 85013, USA.
Objective: Axel Perneczky is responsible for conceptualizing the "keyhole" philosophy as a new paradigm of minimal invasiveness within cranial neurosurgery. Keyhole neurosurgery aims to limit approach-related traumatization and minimize brain retraction while still enabling the neurosurgeon to achieve operative goals. The supraorbital keyhole craniotomy (SOKC) and minipterional (pterional keyhole, PKC) approaches have become mainstays for clipping intracranial aneurysms.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!