Anatomical evaluation of lateral sulcus (sylvian fissure) for temporal intracranial surgical approaches

ABSTRACT Objective: Lateral Sulcus is frequently used surgical corridor of superolateral brain region that separates temporal, parietal and frontal lobes. The purpose of our study is to associate cortical refence points with calvarial landmarks and defining the surgical anatomical structures to gain safety in surgery. Method: In our study, we used 12 adult decapitated cranium, bilaterally 24 formalin fixed hemispherium cerebri specimens that were consisting at the laboratuary of Dokuz Eylül University School of Medicine Departmant of Anatomy. The whole cerebrovascular structures were filled with silicone injections. The landmarks on calvaria were drilled with a high speed drill and projections on duramater were marked. Then the distances between the reference points on LS and the bone reference points on the cranium were measured. Distances were measured with a digital caliper with a sensitivity of 0.01mm. Statistical analyzes were performed. Results: The distance between Sylvian Point (SP)-pterion was 10.00±3.30mm, the distance between SP and zygomatic root was 41.22±7.13mm, the distance between superior temporal line and coronal suture intersection point to SP 32.87±9.69mm, the distance between SP to T7 point 37.45±7.66mm, the distance between squamous suture to SL 6.44±4.63mm. The distance between SP and supramarginal gyrus was 59.54±9,90mm. The distance between anterior ascending ramus-SP was 6.37±1.87mm, the intersection point of precentral sulcus with SL was 11.95±3.70mm. The distance between sylvian point and middle cerebral artery bifurcatio was 18.58±4.21mm. Conclusion: Intraoperative and preoperative planning for neurosurgical procedures of SL region identifiying SL and related structures may play a critical role for safe surgery. Key Words: Lateral Sulcus, Sylvin Point, Pterion, Cadaveric Study