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Technical report
peer-reviewed

Exposure of Dural Venous Sinuses: A Review of Techniques and Description of a Single-piece Troughed Craniotomy



Abstract

Intracranial lesions along the falx and tentorium often require exposure of a dural venous sinus. Craniotomies that cross a sinus should maximize exposure while minimizing the risk of sinus injury and provide a cosmetically appealing result with simple reconstruction techniques. 

We describe the published techniques for exposing dural venous sinuses, and introduce a new technique for a single-piece craniotomy exposing the superior sagittal sinus or transverse sinus using drilled troughs.

A review of the literature was performed to identify articles detailing operative techniques for craniotomies over dural venous sinuses. Our troughed craniotomy for dural sinus exposure is described in detail as well as our experience using this technique in 82 consecutive cases from 2007-2015.

Five distinct techniques for exposure of the dural venous sinus were identified in the literature. In our series of patients undergoing a trough craniotomy, there were no sinus injuries despite a range of various locations and pathology along the sagittal and transverse sinuses. Our technique was found to be safe and simple to reconstruct compared to other techniques found in the literature.

A variety of different techniques for exposing the dural venous sinuses are available. A single-piece craniotomy using a trough technique is a safe means to achieve venous sinus exposure with minimal reconstruction required. Surgeons should consider this method when removing lesions adjacent to the falx or tentorium. 



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Technical report
peer-reviewed

Exposure of Dural Venous Sinuses: A Review of Techniques and Description of a Single-piece Troughed Craniotomy


Author Information

William E. Gordon Corresponding Author

Neurosurgery, University of Tennessee

L. Madison Michael II

Neurosurgery, Semmes-Murphey Clinic

Matthew A. VanLandingham

Neurosurgery, University of Tennessee Health Science Center


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. The study met basic exempt criteria 45 CFR 46.101(b)(4) for IRB approval. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Acknowledgements

The authors wish to thank Andrew J. Gienapp, BA (Department of Medical Education, Methodist University Hospital, Memphis, TN and Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN) for technical and copy editing, preparation of the manuscript and figures for publishing, and publication assistance with this manuscript.


Technical report
peer-reviewed

Exposure of Dural Venous Sinuses: A Review of Techniques and Description of a Single-piece Troughed Craniotomy


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Technical report
peer-reviewed

Exposure of Dural Venous Sinuses: A Review of Techniques and Description of a Single-piece Troughed Craniotomy

  • Author Information
    William E. Gordon Corresponding Author

    Neurosurgery, University of Tennessee

    L. Madison Michael II

    Neurosurgery, Semmes-Murphey Clinic

    Matthew A. VanLandingham

    Neurosurgery, University of Tennessee Health Science Center


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. The study met basic exempt criteria 45 CFR 46.101(b)(4) for IRB approval. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements

    The authors wish to thank Andrew J. Gienapp, BA (Department of Medical Education, Methodist University Hospital, Memphis, TN and Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN) for technical and copy editing, preparation of the manuscript and figures for publishing, and publication assistance with this manuscript.


    Article Information

    Published: February 12, 2018

    DOI

    10.7759/cureus.2184

    Cite this article as:

    Gordon W E, Michael ii L, Vanlandingham M A (February 12, 2018) Exposure of Dural Venous Sinuses: A Review of Techniques and Description of a Single-piece Troughed Craniotomy. Cureus 10(2): e2184. doi:10.7759/cureus.2184

    Publication history

    Received by Cureus: July 08, 2017
    Peer review began: November 02, 2017
    Peer review concluded: February 08, 2018
    Published: February 12, 2018

    Copyright

    © Copyright 2018
    Gordon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Intracranial lesions along the falx and tentorium often require exposure of a dural venous sinus. Craniotomies that cross a sinus should maximize exposure while minimizing the risk of sinus injury and provide a cosmetically appealing result with simple reconstruction techniques. 

We describe the published techniques for exposing dural venous sinuses, and introduce a new technique for a single-piece craniotomy exposing the superior sagittal sinus or transverse sinus using drilled troughs.

A review of the literature was performed to identify articles detailing operative techniques for craniotomies over dural venous sinuses. Our troughed craniotomy for dural sinus exposure is described in detail as well as our experience using this technique in 82 consecutive cases from 2007-2015.

Five distinct techniques for exposure of the dural venous sinus were identified in the literature. In our series of patients undergoing a trough craniotomy, there were no sinus injuries despite a range of various locations and pathology along the sagittal and transverse sinuses. Our technique was found to be safe and simple to reconstruct compared to other techniques found in the literature.

A variety of different techniques for exposing the dural venous sinuses are available. A single-piece craniotomy using a trough technique is a safe means to achieve venous sinus exposure with minimal reconstruction required. Surgeons should consider this method when removing lesions adjacent to the falx or tentorium. 



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Create a free account to continue reading this article.

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