{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T03:09:08Z","timestamp":1778296148541,"version":"3.51.4"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:00:00Z","timestamp":1778284800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:00:00Z","timestamp":1778284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100018573","name":"Istanbul Medeniyet University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100018573","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurosurg Rev"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Extradural anterior clinoidectomy is increasingly used to improve exposure and proximal vascular control in aneurysm surgery, but its isolated effect on an otherwise uncompromised optic nerve remains unclear. To evaluate the functional, structural, and electrophysiological impact of EAC with optic canal unroofing in patients without preoperative optic nerve compression or optic canal pathology. We conducted this single-center study included 16 adults who underwent no-drill extradural anterior clinoidectomy (EAC) during microsurgical clipping of ruptured aneurysms (January 2023\u2013December 2024). Patients with visual or optic pathway pathology were excluded. Postoperative assessment (6\u201312 months) included visual acuity, automated perimetry (visual field index, VFI), OCT\u2013derived retinal nerve fiber layer (RNFL) thickness, and visual evoked potentials (P100 latency). Eyes were compared using paired tests, with repeated-measures ANOVA for quadrant-based \u0394RNFL. Visual acuity was preserved in all patients. Global RNFL thickness was similar in ipsilateral and contralateral eyes (95.8\u2009\u00b1\u200912.7 vs. 99.2\u2009\u00b1\u200918.6 \u03bcm; p\u2009=\u20090.230). Quadrant \u0394RNFL varied by quadrant, but no pairwise differences remained after correction, with a trend toward greater thinning in the superior quadrant. VFI was similar (p\u2009=\u20090.7); one patient had inferior nasal quadrantanopia and two had mild blind-spot enlargement. P100 latency was comparable (114.8\u2009\u00b1\u20099.7 ms vs. 113.8\u2009\u00b1\u20098.9 ms; p\u2009=\u20090.223). No major EAC-related neurovascular complications were observed. Extradural anterior clinoidectomy was not associated with statistically significant optic nerve impairment, although visual field changes occurred in 3\/16 patients (18.75%) with a trend toward superior RNFL thinning.<\/jats:p>","DOI":"10.1007\/s10143-026-04320-y","type":"journal-article","created":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T02:10:27Z","timestamp":1778292627000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of functional, structural, and electrophysiological optic nerve changes following extradural anterior clinoidectomy in patients without preoperative optic canal compression"],"prefix":"10.1007","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2289-2975","authenticated-orcid":false,"given":"Mohammed","family":"Aladdam","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3764-389X","authenticated-orcid":false,"given":"Mehmet Sabri","family":"G\u00fcrb\u00fcz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4830-6394","authenticated-orcid":false,"given":"G\u00fcl\u015fen","family":"\u0130shako\u011flu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9948-5575","authenticated-orcid":false,"given":"Fehim","family":"Esen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0460-3373","authenticated-orcid":false,"given":"Temel","family":"Tombul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2637-1152","authenticated-orcid":false,"given":"Fatih","family":"\u00c7al\u0131\u015f","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,5,9]]},"reference":[{"key":"4320_CR1","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.wneu.2020.11.002","volume":"146","author":"SA Alejandro","year":"2021","unstructured":"Alejandro SA, Carrasco-Hern\u00e1ndez JP, da Costa MDS, Ferreira DS, Lima JVF, de Amorim BL et al (2021) Anterior Clinoidectomy: Intradural Step-by-Step En Bloc Removal Technique. 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J Neurol Surg B Skull Base 78(4):295\u2013300. https:\/\/doi.org\/10.1055\/s-0036-1597813 Epub 2017 Feb 1. PMID: 28725515; PMCID: PMC5515657","journal-title":"J Neurol Surg B Skull Base"},{"key":"4320_CR6","doi-asserted-by":"publisher","unstructured":"Dolenc VV (1985) A combined epi- and subdural direct approach to carotid-ophthalmic artery aneurysms. J Neurosurg. ;62(5):667\u2009\u2013\u200972. https:\/\/doi.org\/10.3171\/jns.1985.62.5.0667. PMID: 3989589","DOI":"10.3171\/jns.1985.62.5.0667"},{"issue":"4","key":"4320_CR7","doi-asserted-by":"publisher","first-page":"295","DOI":"10.2176\/nmc.22.295","volume":"22","author":"A Hakuba","year":"1982","unstructured":"Hakuba A, Nishimura S, Shirakata S, Tsukamoto M (1982) Surgical approaches to the cavernous sinus. Report of 19 cases (author\u2019s transl). Neurol Med Chir (Tokyo) 22(4):295\u2013308. https:\/\/doi.org\/10.2176\/nmc.22.295. Japanese. 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Approval was granted by the Istanbul Medeniyet University Non-Interventional Health Research Ethics Committee (Document No. 2025\/09\u201321).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical Trial Number"}}],"article-number":"400"}}