Background and Introduction: Unlocking of the frontotemporal dural fold (FTDF) and extradural removal of the anterior clinoid process (EACP) are challenging but mandatory skills for micro-neurosurgeons. Despite the presence of an extensive body of literature on this subject, the translation of this cadaveric and 3D simulation to a real patient turns out to be a very demanding and difficult task.
Objective: This video is aimed to address the surgical nuances and major adjustments necessary in the unlocking of the FTDF and extradural ACP removal in an actual case for an early-career neurosurgeon.
Surgical Technique: A 40-year lady presented with features of acromegaly with radiological evidence of significant component of the tumor in the right cavernous sinus along with sellar suprasellar component. To achieve a good hormonal control, a complete tumor excision was required, which was achieved with FTDF and EACP removal. The cavernous sinus was approached through the Parkinson's triangle.
Results: The patient had uneventful recovery and good hormonal control at the 3-month follow-up.
Conclusion: FTDF unlocking and EACP are elegant procedures and need to be learned by all neurosurgeons. This article will provide excellent teaching material for young neurosurgeons.


中文翻译：

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通过解锁额颞叶硬膜皱襞与硬膜外床突切除术走向前外侧颅底：从尸体到临床情景的转化


背景和简介：额颞叶硬膜皱襞 (FTDF) 的解锁和前床突的硬膜外切除 (EACP) 是显微神经外科医生具有挑战性但必须具备的技能。尽管存在大量关于这个主题的文献，但将这种尸体和 3D 模拟翻译成真实的病人是一项非常艰巨和艰巨的任务。
目的：本视频旨在说明在职业生涯早期神经外科医生的实际案例中，解锁 FTDF 和硬膜外 ACP 移除所需的手术细微差别和主要调整。
手术技术：一名 40 岁的女性出现肢端肥大症的特征，放射学证据显示右侧海绵窦内有重要的肿瘤成分以及鞍上成分。为了实现良好的激素控制，需要完全切除肿瘤，这是通过去除 FTDF 和 EACP 来实现的。通过帕金森三角接近海绵窦。
结果：患者在 3 个月的随访中恢复顺利，激素控制良好。
结论： FTDF解锁和EACP是优雅的程序，需要所有神经外科医生学习。本文将为年轻的神经外科医生提供优秀的教材。