Occipital Sinus-Sparing Linear Paramedian Dural Incision: A Technical Note and Case Series for Median Suboccipital Approach

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dc.contributor.authorErol, G.
dc.contributor.authorÇavuşoğlu, N.
dc.contributor.authorSevgi, U.T.
dc.contributor.authorFidan, S.
dc.contributor.authorCanbolat, Ç.
dc.contributor.authorDoğruel, Y.
dc.contributor.authorLuzzi S.
dc.date.accessioned2024-05-19T14:33:46Z
dc.date.available2024-05-19T14:33:46Z
dc.date.issued2024
dc.departmentİstinye Üniversitesien_US
dc.description.abstractBackground: Durotomies, traditionally used during the midline suboccipital approach, involve sacrificing the occipital sinus (OS) with consequent shrinking of the dura, risk of venous complications, difficulty performing watertight closure, and a higher rate of postoperative cerebrospinal fluid (CSF) leaks. The present technical note describes the OS-sparing linear paramedian dural incision, which leads to a decrease in the risk of complications during the median suboccipital approach in our case series. Methods: The OS-sparing linear incision technique involves a dural incision placed 1 cm lateral to the OS. The angle of view of the microscope is frequently changed to overcome the narrowed exposure of the linear durotomy. Copious irrigation with saline prevents drying of the dura. A running watertight closure of the dura is performed. The overall results of 5 cases are reviewed. Results: The cases were 3 tumors and 2 cavernomas. The OS was preserved in all 5, and no duraplasty was needed. The average dura closure time was 16.8 minutes. No CSF leak occurred, and no wound complications were observed. A gross total resection of the lesion was achieved in all the patients. The mean follow-up was 10.2 months, and there were no late complications related to the dura closure. Conclusions: In comparison to the types of durotomies conventionally used for the midline suboccipital approach, the OS-sparing linear paramedian dural incision entails lower risks of bleeding, venous complications, CSF leaks, and infections by avoiding duraplasty. Validation of this technical note on a larger patient cohort is needed. © 2024 Elsevier Inc.en_US
dc.description.sponsorshipConflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.en_US
dc.identifier.doi10.1016/j.wneu.2024.01.070
dc.identifier.endpagee128en_US
dc.identifier.issn1878-8750
dc.identifier.pmid38244681en_US
dc.identifier.scopus2-s2.0-85186994926en_US
dc.identifier.scopusqualityN/Aen_US
dc.identifier.startpagee121en_US
dc.identifier.urihttps://doi.org/10.1016/j.wneu.2024.01.070
dc.identifier.urihttps://hdl.handle.net/20.500.12713/4329
dc.identifier.volume184en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Inc.en_US
dc.relation.ispartofWorld Neurosurgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmz20240519_kaen_US
dc.subjectCsf Leaken_US
dc.subjectDuraplastyen_US
dc.subjectFourth Ventricleen_US
dc.subjectOccipital Sinusen_US
dc.subjectPosterior Fossaen_US
dc.subjectSuboccipital Approachen_US
dc.titleOccipital Sinus-Sparing Linear Paramedian Dural Incision: A Technical Note and Case Series for Median Suboccipital Approachen_US
dc.typeArticleen_US

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