Subfascial Soft-Tissue Dissection in Pterional Craniotomies: A Technical Note

Background: Soft-tissue dissection in pterional craniotomies is done in several different techniques, mostly depending on surgeon's training and preference. When the standard pterional craniotomy was first described, interfacial dissection was recommended to preserve nerve to frontalis function and decrease muscle atrophy. Nowadays, the interfacial dissection and the myocutaneous flap are popular techniques for dissection. The subfascial technique is used by many surgeons who believe that the neurovascular structures in the temporal area are preserved by avoiding the opening of the fascia and keeping these structures intact and retracted away during surgery. In this study, we describe the subfascial dissection technique and aim to measure the pros and cons of this approach subjectively and objectively on functional, radiological, and esthetic outcomes