bone_dust [Neurosurgery Wiki]

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In a study, Tayebi Meybodi et al., sought to develop a hybrid technique based on localization of the [[optic strut]] (OS) to combine the advantages and avoid the disadvantages of both techniques. Ten cadaveric specimens were prepared for surgical simulation. After a standard [[pterional craniotomy]], the [[anterior clinoid process]] (ACP) was resected in 2 steps. The segment anterior to the OS was resected extradurally, while the segment posterior to the OS was resected [[intradural]]ly. The proposed technique was performed in 6 clinical cases to evaluate its safety and efficiency. Anterior [[clinoidectomy]] was successfully performed in all [[cadaver]]ic [[specimen]]s and all 6 patients by using the proposed technique. The extradural phase enabled early decompression of the [[optic nerve]] while avoiding the adjacent [[internal carotid artery]]. The OS was drilled intradurally under direct visualization of the adjacent neurovascular structures. The described [[landmark]]s were easily identifiable and applicable in the surgically treated patients. No operative [[complication]] was encountered. A proposed 2-step hybrid technique combines the advantages of the extradural and intradural techniques while avoiding their [[disadvantage]]s. This technique allows reduced intradural drilling and subarachnoid [[bone dust]] deposition. Moreover, the most critical part of the [[clinoidectomy]]-that is, [[drilling]] of the OS and removal of the body of the ACP-is left for the intradural phase, when critical [[neurovascular]] structures can be directly viewed
((Tayebi Meybodi A, Lawton MT, Yousef S, Guo X, González Sánchez JJ, Tabani H,
García S, Burkhardt JK, Benet A. Anterior clinoidectomy using an extradural and
intradural 2-step hybrid technique. J Neurosurg. 2018 Feb 23:1-10. doi:
10.3171/2017.8.JNS171522. [Epub ahead of print] PubMed PMID: 29473783.
)).