Ezer Haim, Banerjee Anirban Deep, Shorter Cedric, Nanda Anil
Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana.
Skull Base. 2011 May;21(3):159-64. doi: 10.1055/s-0031-1275247.
The "Agnes Fast" craniotomy is a fast and simple way of performing the pterional craniotomy while preserving the temporalis muscle, together with its fascia and bony attachment. Using this technique, the surgeon need not divide the temporalis muscle, separate it from its bony attachment, or perform an interfacial dissection. With a little practice, this craniotomy can be performed in less than 5 minutes and is highly recommended in emergent settings. The modified pterional craniotomy was performed in 10 cadaveric specimens, preserving the temporalis muscle with its attachment. An interfascial dissection was not performed while exposing the frontozygomatic process. The exposure gained, the length of the procedure, and the ease of application were recorded for all heads studied. In all heads studied, the Agnes Fast craniotomy was performed, with complete preservation of the temporalis muscle and its attachments. This procedure was performed quickly, with complete preservation of the fascial nerve and its branches. The muscle was put back in its natural place following the craniotomy. The Agnes Fast craniotomy offers a fast way of performing a pterional craniotomy while preserving the temporalis muscle, with its blood supply, neural innervation, bony attachment, and fascia intact. Replacing the muscle is also fast and simple and involves placement of two CranioFix (Aesculap, Inc., Center Valley, PA) holders to the bone, with no suture material. This approach does not limit the exposure gained and offers the same exposure as the "usual" pterional craniotomy.
“阿格尼斯快速”开颅术是一种快速且简便的翼点开颅术操作方法，同时能保留颞肌及其筋膜和骨附着处。采用这种技术，外科医生无需切开颞肌、将其与骨附着处分离或进行界面分离。稍加练习，这种开颅术可在不到5分钟内完成，在紧急情况下强烈推荐使用。在10个尸体标本上进行了改良翼点开颅术，保留颞肌及其附着处。暴露额颧突时未进行筋膜间分离。记录了所有研究头颅的暴露范围、手术时长和操作难易程度。在所有研究的头颅上均实施了阿格尼斯快速开颅术，颞肌及其附着处得到了完整保留。该手术操作迅速，面神经及其分支得到了完整保留。开颅术后将肌肉放回其自然位置。阿格尼斯快速开颅术提供了一种在保留颞肌及其血供、神经支配、骨附着和筋膜完整的情况下进行翼点开颅术的快速方法。放回肌肉也快速简便，只需将两个颅骨固定器（蛇牌股份公司，宾夕法尼亚州中心谷）固定到骨上，无需缝合材料。这种方法不会限制暴露范围，且能提供与“常规”翼点开颅术相同的暴露效果。
