Please use this identifier to cite or link to this item: http://doi.org/10.25358/openscience-3600
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dc.contributor.authorSerrano Sponton, Lucas Ezequiel
dc.date.accessioned2020-01-20T12:24:58Z
dc.date.available2020-01-20T13:24:58Z
dc.date.issued2020
dc.identifier.urihttps://openscience.ub.uni-mainz.de/handle/20.500.12030/3602-
dc.description.abstractBackground Medially pointing aneurysms of the internal carotid artery’s ophthalmic segment (oICA) represent a neurosurgical challenge. Conventional ipsilateral approaches require ICA and optic nerve (ON) mobilization as well as anterior clinoidectomy (AC), all associated with increased surgical risk. Contralateral approaches could provide a better exposure of oICA’s superomedial aspect, ophthalmic artery (OA) and superior hypophyseal artery (SHA) sparing AC and ICA or ON mobilization. However, the microsurgical anatomy of this approach has not been systematically studied yet. In the present work we exhaustibly analysed the anatomical and morphometric characteristics of contralateral approaches to the oICA and compared them with those from ipsilateral approaches. Methods We assessed 36 ipsi- and contralateral approaches to the oICAs in cadaveric specimens and alive subjects, using for the last a 3D- virtual reality (VR) system. Results Contralateral approaches spared Sylvian fissure dissection and required only minimal frontal lobe retraction. The ipsilateral and contralateral oICA were found at a depth of 49.2±1.8mm (VR: 50.1±2.92mm) and 65.1±1.5mm (VR: 66.05±3.364mm) respectively. The exposure of the superomedial aspect of oICA was 7.25±0.86mm (VR: 6±1mm) contralaterally without ON mobilization and 2.44±0.51mm (VR: 2±1mm) ipsilaterally even after AC. Statistical analysis demonstrated that, for not prefixed chiasm, contralateral approaches achieved a significantly higher exposure of OA, SHA and oICA’s superomedial aspect with its perforating branches (all p<0.01). Conclusion Contralateral approaches may enable a successful exposure of the oICA and related vascular structures, reducing the need of AC or ON mobilization. Systematic clinical/surgical studies are needed to further determine approach’s effectiveness and safety.en_GB
dc.language.isoeng
dc.rightsin Copyrightde_DE
dc.rights.urihttps://rightsstatements.org/vocab/InC/1.0/
dc.subject.ddc610 Medizinde_DE
dc.subject.ddc610 Medical sciencesen_GB
dc.titleEffectiveness of ipsi- and contralateral approaches to the ophthalmic segment of the internal carotid artery : a comparative morphometrical characterization in anatomic specimens and 3D- virtual surgical simulations=Effektivität von ipsi- und kontralateralen Zugängen zum ophthalmischen Abschnitt der Arteria carotis interna : eine komparative morphometrische Charakterisierung in anatomischen Präparaten und 3D-virtuelle chirurgische Simulationenen_GB
dc.typeDissertationde_DE
dc.identifier.urnurn:nbn:de:hebis:77-diss-1000032623
dc.identifier.doihttp://doi.org/10.25358/openscience-3600-
jgu.type.dinitypedoctoralThesis
jgu.type.versionOriginal worken_GB
jgu.type.resourceText
jgu.description.extent107 Blätter
jgu.organisation.departmentFB 04 Medizin-
jgu.organisation.year2020
jgu.organisation.number2700-
jgu.organisation.nameJohannes Gutenberg-Universität Mainz-
jgu.rights.accessrightsopenAccess-
jgu.organisation.placeMainz-
jgu.subject.ddccode610
opus.date.accessioned2020-01-20T12:24:58Z
opus.date.modified2020-01-23T10:34:39Z
opus.date.available2020-01-20T13:24:58
opus.subject.dfgcode00-000
opus.organisation.stringFB 04: Medizin: Neurochirurgische Klinik und Poliklinikde_DE
opus.identifier.opusid100003262
opus.institute.number0441
opus.metadataonlyfalse
opus.type.contenttypeDissertationde_DE
opus.type.contenttypeDissertationen_GB
Appears in collections:JGU-Publikationen

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