Extradural Dolenc Approach to Cavernous Sinus Tumor and Meningo-Orbital Band Management to Anterior Clinoidectomy: Case Report

The Dolenc approach to treating cavernous sinus lesions has been modified over the years to treat various lesions in the parasellar region. An extradural clinoidectomy and proper management of the meningo-orbital band are essential for this approach. A patient with a tumor of the left cavernous sinus underwent a Dolenc extradural approach, and an extradural clinoidectomy was performed through a superior orbital trans-fissure approach. Achieving an extradural clinoidectomy requires special handling of the meningo-orbital band to avoid injuring mid-floor structures, and, on many occasions, access to the anterior clinoid can be performed safely in other ways. Extradural clinoidectomy through superior orbital trans-fissure access is considered safe and preferable in cases of tumor pathology. In addition, lesions confined to the lateral wall of the cavernous sinus can be resected without the need to perform an intradural exploration.