Exposure of the parasellar internal carotid artery (ICA) is one of the most critical and high-risk steps in endoscopic endonasal skull base surgery, yet detailed technical descriptions of controlled ICA skeletonization remain limited. A team led by Gökberk Erol and Joao Paulo Almeida has now published a stepwise demonstration of how the parasellar ICA can be exposed safely, presented through an illustrative surgical video and cadaveric dissections in Acta Neurochirurgica.
The core of the technique is a controlled “brush” method using a diamond burr. The surgeons describe drilling with tangential movements rather than direct pressure, progressively thinning the overlying bone in an egg-shell fashion until it can be safely separated from the arterial wall.
According to the authors, the framework is intended to improve drilling precision, enhance surgeon control, and reduce the risk of vascular injury during parasellar ICA exposure. The technique is presented as a reproducible technical demonstration rather than a study of outcomes; the published work describes the method and its rationale, and does not report comparative safety data or clinical results.
The article is published open access, and the version released on 28 October 2026 is an early, citable version that remains subject to further edits before the final Version of Record appears.
Subject of Research: A technical description of parasellar internal carotid artery exposure in endoscopic endonasal skull base surgery
Article Title: How I do it: parasellar internal carotid artery exposure in endoscopic endonasal surgery
Article References: Erol, G., Kabakcı, A. İ., Sreeenath, S. B., & Almeida, J. P. (2026). How I do it: parasellar internal carotid artery exposure in endoscopic endonasal surgery. Acta Neurochirurgica. https://doi.org/10.1007/s00701-026-07068-y
Image Credits: AI Generated
DOI: 10.1007/s00701-026-07068-y
Keywords: endoscopic endonasal surgery, skull base surgery, internal carotid artery, parasellar ICA, diamond burr, drilling technique, cadaveric dissection, surgical technique, vascular injury prevention, neurosurgery, parasellar, internal
News Source: Ophelia Keating. (October 28, 2026). Stepwise technique for parasellar carotid artery exposure in endoscopic endonasal surgery. Scienmag.
