Department of Neurological Surgery, Hospital Padilla, Tucumán, Argentina.
Department of Neurological Surgery, Hospital Italiano, Buenos Aires, Argentina.
Oper Neurosurg (Hagerstown). 2017 Oct 1;13(5):622-626. doi: 10.1093/ons/opx047.
The pterional approach (PA), together with its variants, is still one of the most common methods used by surgeons to reach the anterior and middle cranial base. A highly important technical detail during a PA is the preservation of the frontotemporal branch of the facial nerve, which can be achieved through an interfascial dissection.
To describe the anatomy of the interfascial vein (IFV), highlighting its recognition as a significant anatomic reference to perform an interfascial dissection (IFD).
Eight adult cadaveric heads, fixed with formaldehyde and injected with colored silicone, were studied. In 6 heads, an IFD was performed, simulating a PA. In the 2 remaining heads, the IFV was dissected. In addition, an IFD was performed in 10 patients, studying the IFV anatomy.
In the 6 cadaveric heads in which the PA with an IFD was performed, and in the 10 patients who underwent a PA with an IFD, the IFV was found. If the interfascial space is divided into thirds, in all cases, the IFV was located within the middle third of the interfascial fat pad. On the 2 cadaveric heads in which the IFV was anatomically dissected, the IFV was also located within the middle third of the interfascial space.
Recognizing the IFV in the interfascial space is of great help as an anatomic landmark to confirm that one is actually between both layers of the superficial temporal fascia.
翼点入路（PA）及其各种改良术式仍然是外科医生到达颅前窝和中颅窝的最常用方法之一。PA 中一个非常重要的技术细节是保护面神经额颞支，可以通过筋膜间解剖来实现。
描述筋膜间静脉（IFV）的解剖结构，强调其作为进行筋膜间解剖（IFD）的重要解剖参考的识别。
研究了 8 个固定在甲醛中的成人尸体头颅，并注入彩色硅胶。在 6 个头颅中进行了 IFD，模拟 PA。在其余 2 个头颅中解剖了 IFV。此外，对 10 名接受 IFD 的患者进行了 PA，研究了 IFV 的解剖结构。
在进行带 IFD 的 PA 的 6 个头颅中，以及在接受带 IFD 的 PA 的 10 名患者中，均发现了 IFV。如果将筋膜间间隙分为三部分，在所有情况下，IFV 均位于筋膜间脂肪垫的中三分之一。在解剖 IFV 的 2 个头颅中，IFV 也位于筋膜间间隙的中三分之一。
在筋膜间间隙中识别 IFV 作为确认自己处于颞浅筋膜两层之间的解剖标志非常有帮助。
