Even though the pterional approach to skull-base lesions has become more widely used by neurosurgeons, significant separation of the frontal and temporal lobes by opening the sylvian fissure is often not done. However, as we have gained more experience, we have opened the sylvian fissure more and more. This has several benefits [3, 5]: (a) small vessels are not compressed by arachnoidal bands during retraction of the brain; (b) there is less resistance (and hence less brain-retractor pressure) to retraction of the frontal lobe; (c) traction on one lobe does not pull and injure the other lobe; (d) fewer bridging veins need be sacrificed; (e) the olfactory nerve usually can be preserved; and (f) there is minimal traction on perforating arteries and on an aneurysm.
KeywordsTemporal Lobe Internal Carotid Artery Middle Cerebral Artery Frontal Lobe Optic Tract
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