Correlation between squamous suture and sylvian fissure: OSIRIX DICOM viewer study

Area of Science:

• Neurosurgery
• Anatomy
• Medical Imaging

Background:

• The Sylvian fissure (SF) is a critical surgical corridor, with its endpoint (eSF) vital for exposing recipient arteries in STA-MCA bypass procedures.
• The relationship between the eSF and external cranial landmarks remains poorly defined, hindering precise surgical navigation.

Purpose of the Study:

• To investigate the correlation between the Squamous Suture (SS) and the Sylvian fissure (SF).
• To establish the SS as a potential external landmark for the eSF in neurosurgical applications.

Main Methods:

• Analysis of 50 adult 3D-CT angiography (CTA) images using OSIRIX DICOM viewer.
• Measurements of SF and SS relative to the external auditory meatus and orbitomeatal (OM) line.
• Comparison of SF and SS positions, including anterior Sylvian point, inferior Rolandic point, and Chater's point (CP).

Main Results:

• The SS is consistently located 1.5 cm below the SF.
• The eSF is identified 1.5 cm superior to the SS at the OM line.
• The SS is a stable bony landmark, offering a reliable reference for locating the eSF, unlike the variable CP.

Conclusions:

• The study successfully mapped the course of the SF and its relationship with the SS.
• The SS is identified as a dependable and simple landmark for the eSF, comparable to Chater's point.
• This research provides crucial anatomical data for improving surgical precision in STA-MCA bypass procedures.