Update on anterior clinoid process removal in anterior clinoid meningioma surgery: literature review, and a new didactical concept

In experienced hands, AC remains an invaluable tool for ACM treatment as it offers more consistent tumor devascularization, prevention of tumor recurrence, optic nerve decompression, and increased working space, which facilitates optimal tumor resection and better long-term control and functional outcome. We propose a new didactical structured concept of routine AC via 2-stage, 4 by 4 steps to improve the utility of AC and decrease associated operative risks compared to selective AC.