Cavernous Sinus Epidermoid Cyst Removal through a No-Keyhole Pterional Craniotomy: Operative Video and Technical Nuances

Carlos Candanedo; Samuel Moscovici; Sergey Spektor

doi:10.1055/s-0041-1727118

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2022; 83(S 03): e623-e624
DOI: 10.1055/s-0041-1727118

Skull Base: Operative Videos

Cavernous Sinus Epidermoid Cyst Removal through a No-Keyhole Pterional Craniotomy: Operative Video and Technical Nuances

Authors

Carlos Candanedo

¹Department of Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
Samuel Moscovici

¹Department of Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
Sergey Spektor

¹Department of Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

Abstract

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Keywords

anterior clinoidectomy - cavernous sinus - epidermoid cyst - oculomotor nerve - operative video - posterior petroclinoid ligament - pterional craniotomy

Fig. 1 (A) Preoperative axial T1 gadolinium-enhanced magnetic resonance imaging showing the right cavernous sinus epidermoid cyst. (B, C) Two different axial views on postoperative diffusion weighted imaging without any sign of restricted diffusion, meaning no signs of tumor residual.

Fig. 2 Intraoperative imaging in the right pterional approach showing (A) neurovascular structures including the optic nerve (CN II), middle cerebral artery, first segment of the anterior cerebral artery (A1) and the distal dural ring exposed thanks to the previously performed extradural anterior clinoidectomy, and (B) severe compression to the oculomotor nerve from the tumor against the posterior petroclinoid dural fold.

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Figures

Fig. 1 (A) Preoperative axial T1 gadolinium-enhanced magnetic resonance imaging showing the right cavernous sinus epidermoid cyst. (B, C) Two different axial views on postoperative diffusion weighted imaging without any sign of restricted diffusion, meaning no signs of tumor residual.

Fig. 2 Intraoperative imaging in the right pterional approach showing (A) neurovascular structures including the optic nerve (CN II), middle cerebral artery, first segment of the anterior cerebral artery (A1) and the distal dural ring exposed thanks to the previously performed extradural anterior clinoidectomy, and (B) severe compression to the oculomotor nerve from the tumor against the posterior petroclinoid dural fold.