Surgical Technique to Retract the Tentorial Edge during Subtemporal Approach: Technical Note

Abstract

We inserted a small straight microclip with one arm through the incision on the surface of the floor of the middle fossa and the other at the free margin of the tentorial edge as a fast and simple method of retracting the tentorial edge during a subtemporal approach.

Deep Bypasses to the Distal Posterior Circulation

“…All measurements were made with digital calipers by using intraoperative photographs and video. In some of the subtemporal approaches, the tentorium was incised behind the entry point of the trochlear nerve, and dural leaflets were retracted laterally with a tacking suture or an aneurysm clip by using the method described by Hernesniemi et al 17 Although this maneuver increased the exposure, it was not used in all subtemporal approaches and varied in length when used. Therefore, the working area of the subtemporal-tentorial triangle was calculated by using the uncut edge of the tentorium.…”

Advances in Open Neurovascular Surgery 2007

“…The technique involves injecting fibrin glue into different cavernous sinus compartments, thus achieving hemostasis. 8 Initially used by Hernesniemi and colleagues for venous hemostasis in the tentorium, 9 the authors have applied the technique to the cavernous sinus using it successfully in 217 surgical cases. No significant clinical side effects were reported.…”

Subtemporal approach to basilar tip aneurysm with division of posterior communicating artery: Technical note

“…The subtemporal approach to treat distal basilar artery aneurysms was introduced by Drake and colleagues (Hernesniemi et al 1992; Drake et al 1996) and is popular in many centers (Dorsch 1988; Mizoi et al 1994; Hernesniemi et al 2005a, 2005b). During this approach, the ipsilateral posterior cerebral artery (PCA) sometimes interferes with visibility and manipulation around the aneurysm neck (Peerless et al 1995; Hernesniemi et al 2005b).…”