The paramedian supracerebellar transtentorial approach to the posterior fusiform gyrus.
The posterior fusiform gyrus lies in a surgically challenging region. Several approaches have been described to access this anatomical area. The paramedian supracerebellar transtentorial (SCTT) approach benefits from minimal disruption of normal neurovascular tissue. The aim of this study was to demonstrate its application to access the posterior fusiform gyrus.



Three brains and six cadaveric heads were examined. A stepwise dissection of the SCTT approach to the posterior fusiform gyrus was performed. Local cortical anatomy was studied. The operability score was applied for comparative analysis on surgical anatomy.



The major posterior landmark used to identify the fusiform gyrus with respect to the medial occipitotemporal gyrus was the collateral sulcus, which commonly bifurcated at its caudal extent. Compared with other surgical approaches addressed to access the region, SCTT demonstrated the best operability in terms of maneuverability arc. Favorable tentorial anatomy is the only limiting factor.



The supracerebellar transtentorial approach is able to provide access to the posterior fusiform gyrus via a minimally disruptive, anatomic, microsurgical corridor.
Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University Hospital, Sydney, Australia.|School of Medicine, University of New England, Armidale, Australia.
Anthony M T
AM
Chau
Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milano, Italy. gagliardi.filippo@hsr.it.
Filippo
F
Gagliardi
School of Medicine, University of New England, Armidale, Australia.
Adam
A
Smith
School of Medicine, University of New England, Armidale, Australia.
Nicholas R
NR
Pelzer
School of Medicine, University of New England, Armidale, Australia.
Fiona
F
Stewart
Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milano, Italy.
Pietro
P
Mortini
Department of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, MO, USA.
Samer K
SK
Elbabaa
Department of Neurosurgery, George Washington University, Washington, DC, USA.
Anthony J
AJ
Caputy
Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University Hospital, Sydney, Australia.|School of Medicine, University of New England, Armidale, Australia.|Department of Neurosurgery, George Washington University, Washington, DC, USA.
Cristian
C
Gragnaniello
D001932:Brain Neoplasms / Q000601:surgery*; D004210:Dissection; D006801:Humans; D019635:Neurosurgical Procedures / Q000379:methods*; D009778:Occipital Lobe / Q000601:surgery*; D013702:Temporal Lobe / Q000601:surgery*
Anatomy; Fusiform gyrus; Neurosurgical procedures; Operability; Supracerebellar transtentorial approach