Abstract
Background Extradural temporopolar approach for paraclinoid lesions can provide extensive and
early exposure of the anterior clinoid process, and complete mobilization and decompression
of the optic nerve and internal carotid artery, which can prevent intraoperative neurovascular
injury. The present study investigated the usefulness of our less invasive modified
technique and discussed its operative nuances.
Methods We retrospectively reviewed medical charts of 80 consecutive patients with neoplastic
(21 patients) and vascular lesions (59 patients) who underwent the modified extradural
temporopolar approach between September 2009 and March 2014.
Results Preoperative visual acuity worsened in 4 patients (5.0%) and worsening of visual
field function occurred in 10 patients (12.5%). Postoperative outcome was good recovery
in 71 patients, moderate disability in 6, severe disability in 2, and death in 1 (due
to reruptured aneurysm). No operation-related mortality occurred in the series.
Conclusion Less invasive modified extradural temporopolar approach is safe and can be recommended
for the surgical treatment of deeply located aneurysms and skull base tumors to reduce
the risk of intraoperative optic neurovascular injury.
Keywords
extradural temporopolar approach - paraclinoid aneurysm - paraclinoid tumors - skull
base technique - anterior clinoid process
