Türe U, Yaşargil M G, Friedman A H, Al-Mefty O
Department of Neurosurgery, Marmara University School of Medicine, Istanbul, Turkey.
Neurosurgery. 2000 Aug;47(2):417-26; discussion 426-7. doi: 10.1097/00006123-200008000-00028.
The fiber dissection technique involves peeling away the white matter tracts of the brain to display its three-dimensional anatomic organization. Early anatomists demonstrated many tracts and fasciculi of the brain using this technique. The complexities of the preparation of the brain and the execution of fiber dissection have led to the neglect of this method, particularly since the development of the microtome and histological techniques. Nevertheless, the fiber dissection technique is a very relevant and reliable method for neurosurgeons to study the details of brain anatomic features.
Twenty previously frozen, formalin-fixed human brains were dissected from the lateral surface to the medial surface, using the operating microscope. Each stage of the process is described. The primary dissection tools were handmade, thin, wooden spatulas with tips of various sizes.
We exposed and studied the myelinated fiber bundles of the brain and acquired a comprehensive understanding of their configurations and locations.
The complex structures of the brain can be more clearly defined and understood when the fiber dissection technique is used. This knowledge can be incorporated into the preoperative planning process and applied to surgical strategies. Fiber dissection is time-consuming and complex, but it greatly adds to our knowledge of brain anatomic features and thus helps improve the quality of microneurosurgery. Because other anatomic techniques fail to provide a true understanding of the complex internal structures of the brain, the reestablishment of fiber dissection of white matter as a standard study method is recommended.
纤维解剖技术是指剥离脑白质束以展示其三维解剖结构。早期解剖学家使用该技术展示了脑的许多束和纤维束。脑标本制备和纤维解剖操作的复杂性导致这种方法被忽视，尤其是自切片机和组织学技术发展以来。然而，纤维解剖技术对于神经外科医生研究脑解剖特征的细节而言是一种非常实用且可靠的方法。
使用手术显微镜，从外侧面向内侧面对20个先前冷冻、经福尔马林固定的人脑进行解剖。描述了该过程的每个阶段。主要解剖工具是手工制作的、薄的、带有各种尺寸尖端的木质刮匙。
我们暴露并研究了脑的有髓纤维束，对其形态和位置有了全面了解。
使用纤维解剖技术时，脑的复杂结构能够得到更清晰的界定和理解。这些知识可纳入术前规划过程并应用于手术策略。纤维解剖耗时且复杂，但它极大地增加了我们对脑解剖特征的了解，从而有助于提高显微神经外科手术的质量。由于其他解剖技术无法真正理解脑的复杂内部结构，建议重新将白质纤维解剖确立为一种标准研究方法。
