RESUMO
OBJECTIVES: The current study aims to increase awareness of the falciform ligament and its anatomical and surgical relationships, for the benefit of the neurosurgeon. PATINENTS AND METHODS: Twenty-four sides from twelve Caucasian cadaveric heads (all fresh-frozen) were used in this study. The length and thickness of the falciform ligament were recorded. The relationship of the falciform ligament to the optic nerve was also observed and documented. Finally, the force needed to avulse the falciform ligament was recorded. RESULTS: In all specimens, the ligament was identified as a continuation of the outer dural layer, forming a roof at the entrance of the optic canal. The mean medial-to-lateral length, anteroposterior length, and thickness of the falciform ligament were 7.97 mm, 2.12 mm, and 0.26 mm, respectively. The mean distance from the medial attachment of the ligament to the midline was 5.54 mm. For the undersurface of the falciform ligament, the optic nerve occupied the middle third in 50.0 %, the lateral third in 44.4 %, and the medial third in 5.6 % of sides. The mean optic nerve diameter at the entrance of the optic canal was 4.20 mm. The mean failure force was 2.47 N. CONCLUSION: The anatomical measurements and relationships provided in this description of the falciform ligament serve as a tool for surgery selection and planning, as well as an aid to improving microsurgical techniques, with the final goal being better patient outcomes.
Assuntos
Ligamentos/anatomia & histologia , Procedimentos Neurocirúrgicos/métodos , Nervo Óptico/anatomia & histologia , Descompressão Cirúrgica/métodos , Humanos , Ligamentos/cirurgia , Microcirurgia/métodos , Nervo Óptico/cirurgiaRESUMO
In this paper, the authors discuss the embryology and anatomy of the choroidal fissure, as well as the pathophysiology and treatment of cerebrospinal fluid cysts of this structure. Understanding its anatomical relations to nearby structures plays an essential role during brain surgeries. With the advancement and availability of imaging techniques, lesions of the choroidal fissure are often found incidentally. Patients are usually asymptomatic or exhibit symptoms that do not correlate with anatomical location or do not require surgical treatment. The choroidal fissure is a key landmark used during brain surgery. Therefore, a comprehensive understanding of it and nearby anatomical structures is essential. Choroidal fissure cysts can be found incidentally, and well-known key features will allow one to differentiate them from other lesions. Surgical treatment should be reserved for symptomatic patients while asymptomatic patients should be monitored.
RESUMO
BACKGROUND: When it comes to autogenous nerve grafting, the sural and great auricular nerve (GAN) are the 2 nerves predominately used for trigeminal and facial nerve repair. Arising from the second and third cervical ventral rami, the GAN emerges from the posterior border of the sternocleidomastoid coursing superiorly and anteriorly toward the ear. METHODS: Eleven sides from 5 Caucasian and 1 Asian cadaveric heads (all fresh-frozen) were used. One man and 5 women were used with an age at death ranging from 57 to 91 years, with a mean of 80.3 years. Measurements were made from the inferior border of the ear to the GAN, the GAN to the external jugular vein, and the inferior border of the mastoid process to the GAN; the proximal, medial, and distal diameters of the GAN and the length of the GAN that was obtained from this exposure were also measured. RESULTS: The mean distance from the inferior border of the mastoid process to the GAN, inferior border of the ear to the GAN, and GAN to the external jugular vein was 27.71, 31.03, and 13.28 mm, respectively. The mean length of the GAN was 74.86 mm. The mean diameter of its distal, middle, and proximal portions was 1.51, 1.38, and 1.58 mm, respectively. CONCLUSIONS: The GAN is an excellent option for use in nerve grafting for repair of, for example, facial dysfunction. In this study, we review our measurements, techniques for identification, and dissecting techniques for the GAN. The proximity to the operative area and minimal complications associated with GAN grafting might contribute to improved patient satisfaction and better outcomes regarding functional restoration.