Extradural anterior clinoidectomy and optic intra-canalicular approach for ciliary ganglion paraganglioma resection

Abstract Background Paragangliomas of the ciliary ganglion are exceptionally rare, and intra-canalicular extension causing optic nerve compression is, to our knowledge, an exceptional presentation. Methods The anatomy and the surgical technique of extradural anterior clinoidectomy (EAC) in a case with an intra-canalicular ciliary ganglion paraganglioma has been described, accompanied by a video to illustrate EAC, including optic canal unroofing. Conclusion Anterior clinoid process is localized amongst critical structures and the technique of EAC needs to be mastered to ensure a safe procedure. Optic unroofing facilitates complete lesion resection in patients presenting with intra-canalicular lesions causing optic compression.