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Extradural Clinoidectomy

Last Updated: September 27, 2018

Extradural Clinoidectomy: Expanding the Paraclinoid Space

General Considerations

Anterior clinoidectomy is an important tool for neurovascular and skull base surgery. This technique is cardinal for expanding access to the proximal carotid artery, optic nerve, sella and the central skull base. The goal of anterior clinoidectomy is to reveal the more proximal ophthalmic and clinoidal segments of the internal carotid artery (ICA) while skeletonizing the proximal optic nerve. This maneuver expands the optico-carotid and carotid-oculomotor windows and therefore the operative corridor to the interpeduncular cisterns—both the carotid artery and optic nerve are partially untethered or liberated and can be more safely mobilized.

Controversy surrounds the value of clinoidectomy for “appropriate...