scholarly journals Letter: Impact of Anterior Clinoidectomy on Visual Function After Paraclinoid Carotid Artery Aneurysm Surgery: Power-Drill Versus No-Drill Technique

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Eberval Gadelha Figueiredo ◽  
Nicollas Nunes Rabelo ◽  
Leonardo C Welling ◽  
Manoel Jacobsen Teixeira
Keyword(s):  
Carotid Artery ◽  
Visual Function ◽  
Artery Aneurysm ◽  
Aneurysm Surgery ◽  
Anterior Clinoidectomy ◽  
Carotid Artery Aneurysm ◽  
Power Drill

scholarly journals Role of superior hypophyseal artery in visual function impairment after paraclinoid carotid artery aneurysm surgery

2015 ◽  
Vol 123 (2) ◽  
pp. 460-466 ◽  
Author(s):  
Tetsuyoshi Horiuchi ◽  
Tetsuya Goto ◽  
Yuichiro Tanaka ◽  
Kunihiko Kodama ◽  
Keiji Tsutsumi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Visual Function ◽  
Artery Aneurysm ◽  
University Hospital ◽  
Aneurysm Surgery ◽  
Simultaneous Treatment ◽  
Carotid Artery Aneurysm ◽  
Function Impairment ◽  
The Relationship

OBJECT Although a number of studies have assessed the surgical treatment of paraclinoid-segment carotid artery aneurysms and resulting visual complications, less attention has been given to the results with respect to the superior hypophyseal artery (SHA). The authors evaluated the relationship between the aneurysm, the SHA itself, and postoperative visual function in patients with ruptured and unruptured SHA aneurysms. METHODS From January 1991 through December 2013, 181 patients with 190 paraclinoid carotid artery aneurysms received treatment at Shinshu University Hospital and its affiliated hospitals. The authors retrospectively analyzed charts, operative records, operative videos, and neuroimaging findings for these patients with or without postoperative visual complications. RESULTS The authors identified 72 SHA aneurysms in 70 patients (mean age 58 years). Of 69 patients (1 patient died) evaluated, postoperative visual complications occurred in 9 (13.0%). Although the aneurysm size and SHA sacrifice did not lead to postoperative visual impairment, simultaneous treatment of bilateral aneurysms was a risk factor for postoperative visual complications. CONCLUSIONS Unilateral SHA impairment may be safe (i.e., it may not induce ischemia of the optic pathway) for many, but not all, patients with SHA aneurysm.

scholarly journals Impact of Anterior Clinoidectomy on Visual Function After Paraclinoid Carotid Artery Aneurysm Surgery: Power-Drill Versus No-Drill Technique

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Takeya Niibo ◽  
Katsumi Takizawa ◽  
Jurou Sakurai ◽  
Seizi Takebayashi ◽  
Hiroyasu Koizumi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Visual Impairment ◽  
Nerve Palsy ◽  
Artery Aneurysm ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Anterior Clinoidectomy ◽  
Visual Outcomes ◽  
Disturbance Of Consciousness ◽  
Power Drill

ABSTRACT BACKGROUND Few studies have attempted to make a direct comparison of the risk of visual impairment following extradural anterior clinoidectomy (EAC) with and without the use of a power drill. OBJECTIVE To evaluate postoperative visual outcomes between groups of patients with paraclinoid carotid artery aneurysms (PCAAs) who underwent surgical clipping with and without the use of a power drill during EAC. METHODS Between January 2010 and November 2019, 90 patients, 7 with ruptured and 83 with unruptured PCAAs, underwent clipping surgery at our hospital. The authors retrospectively analyzed postoperative visual complications from the medical records of these patients. RESULTS Among the 85 patients (excluding 3 patients with disturbance of consciousness caused by subarachnoid hemorrhage and 2 patients with preoperative visual disturbance) evaluated, EAC was conducted using a power drill in 64 patients and using a microrongeur in 21 patients. Permanent postoperative visual impairment developed in 14 (21.9%) patients in the drill group: 9 patients had ipsilateral lower nasal quadrant hemianopsia (ILNQH) and 5 patients had ipsilateral visual acuity reduction. Transient ILNQH developed in only 1 patient in the no-drill group. The incidence of permanent postoperative visual impairments was significantly lower in the no-drill group than in the drill group (P = .020). Seventeen (26.6%) patients developed transient oculomotor nerve palsy in the drill group, while no patients developed oculomotor nerve palsy in the no-drill group. CONCLUSION EAC using a microrongeur versus a power drill significantly improved visual outcomes after clipping surgery for PCAAs.

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