Surgical Anatomy and Techniques
SURGICAL ANATOMY AND TECHNIQUES MICROSURGICAL APPROACHES TO THE MEDIAL TEMPORAL REGION:AN ANATOMICAL STUDY Alvaro Campero, M.D. OBJECTIVE: To describe the surgical anatomy of the anterior, middle, and posterior Department of Neurological Surgery, portions of the medial temporal region and to present an anatomic-based classification University of Florida, of the approaches to this area. Gainesville, Florida METHODS: Twenty formalin-fixed, adult cadaveric specimens were studied. Ten brains Gustavo Tro´ccoli, M.D. provided measurements to compare different surgical strategies. Approaches were demon- Department of Neurological Surgery, strated using 10 silicon-injected cadaveric heads. Surgical cases were used to illustrate the Hospital “Dr. J. Penna,” results by the different approaches. Transverse lines at the level of the inferior choroidal point Bahı´a Blanca, Argentina and quadrigeminal plate were used to divide the medial temporal region into anterior, middle, and posterior portions. Surgical approaches to the medial temporal region were classified into Carolina Martins, M.D. four groups: superior, lateral, basal, and medial, based on the surface of the lobe through which Department of Neurological Surgery, University of Florida, the approach was directed. The approaches through the medial group were subdivided further Gainesville, Florida into an anterior approach, the transsylvian transcisternal approach, and two posterior ap- proaches, the occipital interhemispheric and supracerebellar transtentorial approaches. Juan C. Fernandez-Miranda, M.D. RESULTS: The anterior portion of the medial temporal region can be reached through Department of Neurological Surgery, University of Florida, the superior, lateral, and basal surfaces of the lobe and the anterior variant of the Gainesville, Florida approach through the medial surface.
[Show full text]