Skull Base 2005; 15(3): 157-161
DOI: 10.1055/s-2005-871523
ORIGINAL ARTICLE

Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Enhanced Exposure of Carotico-Oculomotor Triangle Following Extradural Anterior Clinoidectomy: A Comparative Anatomical Study

Burak Sade1 , 2 , Chang Y. Kweon3 , James J. Evans1 , 2 , Joung H. Lee1 , 2
  • 1Brain Tumor Institute, The Cleveland Clinic Foundation, Cleveland, Ohio
  • 2Department of Neurosurgery, The Cleveland Clinic Foundation, Cleveland, Ohio
  • 3Department of Neurosurgery, Presbyterian Medical Center, Chunju, South Korea
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Publikationsdatum:
30. Juni 2005 (online)

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ABSTRACT

Objective: To quantify and compare the carotico-oculomotor triangle (COT) area before and after extradural anterior clinoidectomy (AC). Methods: Ten cadaveric heads were dissected bilaterally. Before and after an extradural AC, the following points were measured: (1) the internal carotid artery (ICA) bifurcation to the tip of the anterior clinoid process (ACP) (A) and to the distal dural ring (A′), (2) the ICA bifurcation to the point where the oculomotor nerve becomes obscured by the tentorial fold (B) and to the porus oculomotoris after incision of the tentorial fold (B′), and (3) the tip of the ACP to the point where the oculomotor nerve becomes obscured by the tentorial incisura (C) and from the distal dural ring to the porus oculomotoris (C′). The area of the COT was calculated before and after AC (ΔABC and ΔA′B′C′, respectively). Results: The mean values were as follows: A: 9.15 ± 0.93 mm, A′: 13.45 ± 0.82 mm; B: 7.80 ± 1.24 mm, B′: 9.90 ± 1.21 mm; C: 7.15 ± 0.99 mm, C′: 9.3 ± 1.26 mm; ΔABC: 26.26 ± 6.05 mm2, ΔA′B′C′: 45.06 ± 8.92 mm2. Conclusions: Extradural AC enhances the exposure of the COT almost twofold. This increased exposure can be of significant help during resection of lesions of the parasellar and basilar apex regions.

REFERENCES

Joung H LeeM.D. 

Brain Tumor Institute, Department of Neurosurgery

The Cleveland Clinic Foundation, Desk R-20, 9500 Euclid Ave.

Cleveland, OH 44195

eMail: leej@cc.ccf.org