Safety around Sylvian Fissure: Technical Note

Abstract

ABSTRACT Background: Sylvian fissure dissection is one of the most important neurosurgical procedures for a number of vascular, neoplastic and other (epilepsy) neurological ailments. Safe dissection in this region is of utmost importance, especially for trainees and young Neurosurgeons. The authors highlight some of the important and basic safety tips so that surgery is without unwarranted complications. Material and Methods: Technical difficulties, most commonly faced by trainees and young neurosurgeons during Microneurosurgery around the sylvian fissure, were identified based on experiences of senior authors and were related to: Surgical Planning, Head positioning, Dural opening, use of Macro and Microinstruments, Microdissection and closure. Technical details of steps which are safe and easy to address above mentioned difficulties were outlined. Results: Safe and easy technique to perform Microneurosurgery around sylvian fissure have been mentioned with special attention to the difficulties faced by trainees and young neurosurgeons. It includes all technical aspects starting from planning the surgery to closure of the wound. Conclusion: Microneurosurgery around sylvian fissure is the most important expertise to address variety of vascular and neoplastic lesions in neurosurgery. Sound concepts of basic neuroanatomy and basic principles of physics help in planning and performing Microneurosurgery safely in the region of sylvian fissure.