Entry Point to the Sylvian Fissure for the Pterional Transsylvian Approach
| العنوان: | Entry Point to the Sylvian Fissure for the Pterional Transsylvian Approach |
|---|---|
| المؤلفون: | Hirofumi Hirano, Kazuho Hirahara, Tomoko Hanada, Kazunori Arita, K. Mamitsuka, Hiroshi Tokimura, R. Hanaya, Sei Sugata, Hitoshi Yamahata, T. Ishii |
| المصدر: | Journal of Neurological Surgery Part A: Central European Neurosurgery. 74:228-233 |
| بيانات النشر: | Georg Thieme Verlag KG, 2013. |
| سنة النشر: | 2013 |
| مصطلحات موضوعية: | Adult, Male, Subarachnoid hemorrhage, Adolescent, Ruptured aneurysms, medicine.medical_treatment, Dissection (medical), Aneurysm, Ruptured, Neurosurgical Procedures, Young Adult, Sphenoid Bone, Image Processing, Computer-Assisted, medicine, Humans, Prospective Studies, Craniotomy, Aged, Fissure, business.industry, Skull, Infarction, Middle Cerebral Artery, Intracranial Aneurysm, Anatomy, Clipping (medicine), Middle Aged, medicine.disease, Entry site, medicine.anatomical_structure, Female, Surgery, Neurology (clinical), Tomography, X-Ray Computed, business, Intracranial Hemorrhages, Carotid Artery, Internal, Brain retraction |
| الوصف: | Background Although the anatomy of the Sylvian fissure is understood, there is little information on where to start its dissection in the pterional transsylvian (PT-TS) approach. At small craniotomy using the PT-TS approach, we set the entry point to the Sylvian fissure at 15 mm behind the anterior edge of the craniotomy along the Sylvian fissure and designated this site “point 15.” Here we compared the utility of “point 15” with the Sylvian point (point on the Sylvian fissure giving rise to the horizontal and anterior ascending rami) that had been recommended earlier as the entry site for opening the Sylvian fissure. Materials and Methods This study includes 16 patients with 7 ruptured and 9 unruptured anterior circulation aneurysms. We evaluated the usefulness of “point 15” in the PT-TS approach for aneurysmal neck clipping with respect to the adequacy of anatomical exposure and low invasiveness. Results In 12 patients “point 15” provided for excellent anatomical exposure of the Sylvian fissure; complete neck clipping was possible with minimal brain retraction and damage. In two patients with ruptured aneurysms and thick subarachnoid hemorrhage and in two patients with unruptured aneurysms, the dissection had to be enlarged 3 to 4 mm distally without reaching the Sylvian point. In the latter two patients the Sylvian veins were tethered to frontal and temporal lobes. Conclusions The “point 15” was an easily set entry point to the Sylvian fissure. It provided for sufficient anatomical exposure at surgery for anterior circulation aneurysms; additional posterior dissection was required in rare cases. We found that “point 15” was useful in small craniotomies using the PT-TS approach. |
| تدمد: | 2193-6323 2193-6315 |
| DOI: | 10.1055/s-0033-1341414 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3dd2284c2bed4e2aa157031a46c82f9d https://doi.org/10.1055/s-0033-1341414 |
| رقم الانضمام: | edsair.doi.dedup.....3dd2284c2bed4e2aa157031a46c82f9d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 21936323 21936315 |
|---|---|
| DOI: | 10.1055/s-0033-1341414 |