{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T20:05:19Z","timestamp":1782504319039,"version":"3.54.5"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T00:00:00Z","timestamp":1695772800000},"content-version":"vor","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003The study aimed to provide neuroanatomical justification of the extradural resection of the anterior clinoid process (ACP).<\/jats:p><jats:p>\n          Material and Method\u2003Using a cross-sectional study design, 47 cranial computed tomography (CT) scans were examined. There were 31 (65.96%) females aged 28 to 79 years. The measured dimensions were ACP length and width, and optic strut (OS) width. Index (iacp) was measured as the ratio of ACP width to ACP length. The ACP volume and working operating field (WOF) volume were measured using Syngo.via Siemens program. The percentage expansion of WOF after removal of the ACP was estimated on 5 fixed human cadaver heads with the exoscope VITOM 3D. The possibilities of the combined approach were demonstrated in a clinical case.<\/jats:p><jats:p>\n          Results\u2003The mean ACP lengths were 11.31\u2009\u00b1\u20092.76 and 11.54\u2009\u00b1\u20092.86\u2009mm, on the right and left, respectively. The mean ACP widths were 7.70\u2009\u00b1\u20091.66 and 7.64\u2009\u00b1\u20091.67\u2009mm, on the right and left, respectively. Average iacp was 0.67 (minimum 0.45; maximum 0.90). The width of the OS varied in the range from 1.37 to 4.75\u2009mm. The average volume of right ACP was 0.71\u2009\u00b1\u20090.16\u2009cm3, right WOF was 3.26\u2009\u00b1\u20090.74\u2009cm3, left ACP was 0.71\u2009\u00b1\u20090.15\u2009cm3, left and WOF was 3.20\u2009\u00b1\u20090.76\u2009cm3. Removal of the right ACP expanded the right WOF by 22.21\u2009\u00b1\u20093.88%, and left ACP by 22.78\u2009\u00b1\u20095.50%. There was an approximately 25% increase in the WOF from the cadaveric dissections. Taking into account the variability of the ACP and OS, we proposed our own surgical classification of complicated (iacp \u2265 0.67; medium OS 2.5\u2009mm \u2264 4.0\u2009mm; wide OS \u2265 4.0\u2009mm; ACP with pneumatization) and uncomplicated ACP (iacp 0.45 \u2264 0.67\u2009mm; iacp \u2264 0.45; narrow OS \u2264 2.5\u2009mm; ACP without pneumatization). Using this classification, we developed an algorithm for ACP dissection and removal. This was piloted in a clinical case of microsurgical clipping of a left internal carotid artery-posterior communicating artery aneurysm via the left minipterional approach.<\/jats:p><jats:p>\n          Conclusion\u2003Extradural removal of ACP expands the WOF by approximately 25%, it helps neurosurgeons to improve proximal vascular control and avoid complications, and expands the range of indications for neurosurgical interventions in the skull base area.<\/jats:p>","DOI":"10.1055\/s-0043-1771373","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T23:27:21Z","timestamp":1695857241000},"page":"573-580","source":"Crossref","is-referenced-by-count":1,"title":["Anatomical Justification of Extradural Resection of the Anterior Clinoid Process"],"prefix":"10.1055","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7580-0385","authenticated-orcid":false,"given":"Albert A.","family":"Sufianov","sequence":"additional","affiliation":[{"name":"Department of Nerosurgery, I.M. Sechenov, First Moscow State Medical University (Sechenov University), Moscow, Russian Federation"},{"name":"Department of Neurosurgery, Federal Centre of Neurosurgery, Ministry of Health of the Russian Federation, City of Tyumen, Russian Federation"},{"name":"Department of Neurosurgery, Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation"},{"name":"Department of Neurosurgery, King Edward Medical University (KEMU), Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iurii A.","family":"Iakimov","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Federal Centre of Neurosurgery, Ministry of Health of the Russian Federation, City of Tyumen, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nargiza A.","family":"Garifullina","sequence":"additional","affiliation":[{"name":"Department of Nerosurgery, I.M. Sechenov, First Moscow State Medical University (Sechenov University), Moscow, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinat A.","family":"Sufianov","sequence":"additional","affiliation":[{"name":"Department of Nerosurgery, I.M. Sechenov, First Moscow State Medical University (Sechenov University), Moscow, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman V.","family":"Kovalenko","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Federal Centre of Neurosurgery, Ministry of Health of the Russian Federation, City of Tyumen, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idrisdzhoni A.","family":"Kosimzoda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Federal Centre of Neurosurgery, Ministry of Health of the Russian Federation, City of Tyumen, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,9,27]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.47093\/2218-7332.2021.12.4.51-63","article-title":"How I do it: microsurgical clipping of carotid-ophthalmic aneurysms through minipterional approach with extradural resection of the anterior clinoid process","volume":"12","author":"A A Sufianov","year":"2021","journal-title":"Sechenov Med J"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"2098","DOI":"10.1097\/SCS.0b013e31829ae3af","article-title":"Anterior clinoid process and the surrounding structures","volume":"24","author":"Y Cheng","year":"2013","journal-title":"J Craniofac Surg"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.wneu.2017.08.083","article-title":"Vitom 3d: Preliminary experience in cranial surgery","volume":"107","author":"Z Rossini","year":"2017","journal-title":"World Neurosurg"},{"issue":"01","key":"ref4","first-page":"7","article-title":"The microsurgical approach to intracranial aneurysms","volume":"3","author":"M G Yasargil","year":"1975","journal-title":"Surg Neurol"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.3171\/2014.11.JNS146","article-title":"Prospective randomized study comparing clinical, functional, and aesthetic results of minipterional and classic pterional craniotomies","volume":"122","author":"L C Welling","year":"2015","journal-title":"J Neurosurg"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.jocn.2015.07.032","article-title":"Surgical experience of minipterional craniotomy with 102 ruptured and unruptured anterior circulation aneurysms","volume":"27","author":"E G Figueiredo","year":"2016","journal-title":"J Clin Neurosci"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1016\/j.wneu.2013.02.072","article-title":"The pterional and suprabrow approaches for aneurysm surgery: a systematic review of intraoperative rupture rates in 9488 aneurysms","volume":"80","author":"V S Madhugiri","year":"2013","journal-title":"World Neurosurg"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"200","DOI":"10.4103\/sni.sni_169_17","article-title":"Horizontal distance of anterior communicating artery aneurysm neck from anterior clinoid process is critically important to predict postoperative complication in clipping via pterional approach","volume":"8","author":"T Fujii","year":"2017","journal-title":"Surg Neurol Int"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.wneu.2017.09.058","article-title":"Minipterional and supraorbital keyhole craniotomies for ruptured anterior circulation aneurysms: experience at single center","volume":"109","author":"H Tra","year":"2018","journal-title":"World Neurosurg"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1016\/j.wneu.2015.07.055","article-title":"Retractorless surgery for anterior circulation aneurysms via a pterional keyhole approach","volume":"84","author":"L H Yu","year":"2015","journal-title":"World Neurosurg"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1007\/s10143-018-1053-y","article-title":"Supraorbital keyhole versus pterional craniotomies for ruptured anterior communicating artery aneurysms: a propensity score-matched analysis","volume":"43","author":"L B Yu","year":"2020","journal-title":"Neurosurg Rev"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1007\/s10143-019-01219-9","article-title":"The extradural minipterional approach for the treatment of paraclinoid aneurysms: a cadaver stepwise dissection and clinical case series","volume":"43","author":"R Martinez-Perez","year":"2020","journal-title":"Neurosurg Rev"},{"issue":"04","key":"ref13","first-page":"484","article-title":"Microsurgical anatomy and variations of the anterior clinoid process","volume":"24","author":"A Dagtekin","year":"2014","journal-title":"Turk Neurosurg"},{"issue":"02","key":"ref14","first-page":"141","article-title":"A study on anterior clinoid process and optic strut with emphasis on variations of caroticoclinoid foramen","volume":"7","author":"N Gupta","year":"2005","journal-title":"Nepal Med Coll J"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1007\/s00276-008-0346-1","article-title":"Metrical and non-metrical study of anterior clinoid process in South Indian adult skulls","volume":"30","author":"S Hunnargi","year":"2008","journal-title":"Surg Radiol Anat"},{"issue":"03","key":"ref16","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.jocn.2003.08.005","article-title":"Surgical anatomy of the anterior clinoid process","volume":"11","author":"P Huynh-Le","year":"2004","journal-title":"J Clin Neurosci"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"151","DOI":"10.3349\/ymj.1997.38.3.151","article-title":"Anterior clinoid process and optic strut in Koreans","volume":"38","author":"H Y Lee","year":"1997","journal-title":"Yonsei Med J"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.4067\/S0717-95022016000400026","article-title":"Pre-operative measurement of the morphometry and angles of the anterior clinoid process (ACP) for aneurysm surgery","volume":"34","author":"A Cecen","year":"2016","journal-title":"Int J Morphol"},{"issue":"02","key":"ref19","doi-asserted-by":"crossref","first-page":"88","DOI":"10.17305\/bjbms.2012.2502","article-title":"Anatomical variations and morphometric study of the optic strut and the anterior clinoid process","volume":"12","author":"E Kapur","year":"2012","journal-title":"Bosn J Basic Med Sci"},{"issue":"03","key":"ref20","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.jocn.2003.08.005","article-title":"Surgical anatomy of the anterior clinoid process","volume":"11","author":"P Huynh-Le","year":"2004","journal-title":"J Clin Neurosci"},{"issue":"03","key":"ref21","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.ejrad.2003.08.012","article-title":"Remarkable anatomic variations in paranasal sinus region and their clinical importance","volume":"50","author":"M Kantarci","year":"2004","journal-title":"Eur J Radiol"}],"container-title":["Asian Journal of Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1771373.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T10:27:00Z","timestamp":1730802420000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1771373"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":21,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2023,12,25]]},"published-print":{"date-parts":[[2023,9]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1771373","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1793-5482","2248-9614"],"issn-type":[{"value":"1793-5482","type":"print"},{"value":"2248-9614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9]]}}}