• Ana Flores-Justa, Matias Baldoncini, Julio C Pérez Cruz, Sánchez Gonzalez Federico F Epilepsy Surgery Section, Neurosurgical Division, Clinical Hospital, University of Buenos Aires, Buenos Aires, Argentina; Neurosurgical Divisi, Oscar A Martínez, Pablo González-López, and Álvaro Campero.
• Department of Neurological Surgery, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Laboratory of Neuroanatomic Microsurgical-LaNeMic-II Division of Anatomy, Medicine School, University of Buenos Aires, Buenos Aires, Argentina. Electronic address: annaflores36@gmail.com.
• World Neurosurg. 2019 Dec 1; 132: e670-e679.

BackgroundThe temporal lobe is an important and complex anatomic region of the brain. Accurate knowledge of anatomic relationships becomes extremely relevant when deciding surgical strategy, such as epilepsy or oncologic surgery, involving this lobe. To our knowledge, there is no strong literature highlighting the relationship between white matter tracts and craniometric landmarks applied to temporal lobe surgery. We aim to describe the topographic relationship between the craniometric points and white matter tracts of the temporal lobe through dissection of cadaveric specimens and describe the potential preoperative usefulness of diffusion tensor imaging in relation to the anatomic features found during the dissections.MethodsFifteen formalin-fixed whole cadaveric heads were dissected by the Klingler technique in a stepwise manner across the temporal and sphenoid bone windows. The white matter pathways were identified in their different planes and their position was described in relation to craniometric landmarks. Diffusion tensor studies were performed in 2 healthy volunteers to analyze the temporal fasciculi in vivo.ResultsWe identified the topographic relationships between craniometric points and relevant association tracts that lie within the cranial corridors (superior and inferior frontal, parietal, occipital, sphenoidal, and temporal). Important landmarks were defined in correspondence to these different fasciculi.ConclusionsThrough this kind of microsurgical anatomic study, a better understanding of the different anatomic layers of the temporal region might be achieved. This factor is essential in planning adequate surgery and strategies to operate in the temporal lobe, improving surgical results and minimizing functional deficits.Copyright © 2019 Elsevier Inc. All rights reserved.

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