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J Neurol Surg B Skull Base 2018; 79(S 04): S378-S382
DOI: 10.1055/s-0038-1660843
WFSBS 2016
Georg Thieme Verlag KG Stuttgart · New York

Usefulness of Preoperative Simulation in Skull Base Approach: A Case Report

Manish Kolakshyapati
1   Department of Neurosurgery, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
,
Fusao Ikawa
1   Department of Neurosurgery, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
,
Masaru Abiko
1   Department of Neurosurgery, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
,
Takafumi Mitsuhara
1   Department of Neurosurgery, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
,
Masaaki Takeda
1   Department of Neurosurgery, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
,
Tejashwi Shrestha
2   Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
,
Kaoru Kurisu
1   Department of Neurosurgery, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
› Author Affiliations
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Publication History

17 February 2018

11 May 2018

Publication Date:
28 June 2018 (online)

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Abstract

Skull base approach is a neurosurgical challenge requiring dexterity of the operating surgeon for good postoperative outcome. In addition to the experience of the operating surgeon, adequate preoperative information of the tumor is necessary to ensure better outcome. In clinoid meningioma, it is sometimes difficult to determine its relationship with the surrounding structure and the feeding artery. Previously, preoperative simulation has been utilized to determine the intracranial course of the compressed nerves in relation to the petroclival meningioma. We report a case of clinoid meningioma where preoperative fusion of three dimensional computed tomography angiography (3D-CTA) and 3T-fast imaging employing steady-state acquisition (FIESTA) images was useful in determining the exact location of the feeding artery to devascularize the tumor and aid in surgery. Preoperative simulation with three-dimensional digital subtraction angiography (3D-DSA) and 3T-FIESTA fusion images can be a useful adjunct tool to supplement surgery and to train neurosurgical trainees.

Keywords

preoperative simulation - skull base - 3D-CTA - FIESTA - clinoid meningioma - feeding artery
 

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