Abstract
The transclinoid approach reported by Dolenc for cavernous sinus exposure was used for 30 cases of carotid ophthalmic aneurysms, carotid cavernous sinus portion aneurysms, distal basilar artery aneurysms and some other lesions in 1992 and 1993 and was found useful for several aspects in each lesion. The lesions were internal carotid artery aneurysms in 17 cases (carotid canal portion aneurysm in 1 case, cavernous portion aneurysms in 9 cases, ophthalmic aneurysms in 6 cases), and basilar artery aneurysms in 12 patients (basilar bifurcation aneurysms in 2 cases, basilar superior cerebellar artery aneurysms in 10 cases). The first advantage is that a wide working space can be obtained around the periclinoidal carotid artery, so that the proper clipping can be done with a suitable clip or clips if necessary without obstruction of the field by the clip holder. The second advantage is that it is possible to secure the proximal part of the basilar artery in the early stage of operation for temporary clipping at any time. This advantage would be particularly worthwhile in cases of distal basilar artery aneurysms.
