Applied anatomy of large unilateral frontotemporoparietal decompressive craniectomy

Abstract

Objective To study the anatomy of unilateral frontotemporoparietal structures of the Chinese people and to provide the anatomical basis for approach design in large craniectomy. Methods Large unilateral frontotemporoparietal decompressive craniectomy were performed on 15 corpse skulls. Through dissection layer by layer, anatomical landmarks were identified and relevant data were documented. Results The vertical distance between the distal point of posterior edge of parietal eminence and the external auditory canal was 79.90±4.06 mm. The distance from the midpoint between nasal root and external occipital protuberance to the midpoint of zygomatic arch was 144.60±4.73 mm. The distance between the eyebrow arch and the parietal eminence was 163.50±4.75 mm. Within the bone window, the longest distance between arachnoid granulation in the superior sagittal and midline was 19.62±3.98 mm. The vertical distance between the superior margin of zygomatic arch and the point where the Sylvian vein drains into sphenoparietal sinus was 25.26±3.77 mm. Conclusions In order to achieve adequate decompression, the vertical distance from the farthest point of skin incision around parietal eminence to the external auditory canal should not be less than 8 cm, the bone window could be 2 cm from the midline, and the lower margin of the bone could be located at the upper margin of zygomatic arch. Key words: Craniology; Anatomy; Decompressive hemicraniectomy