Interfascial approach for pterional craniotomy: technique and adjustments to prevent cosmetic complications

  • Guillaume BaucherEmail author
  • Florian Bernard
  • Thomas Graillon
  • Henry Dufour
How I Do it - Neurosurgical Anatomy
Part of the following topical collections:
  1. Neurosurgical anatomy



Interfascial dissection for pterional craniotomy is one of the main techniques to expose the pterional region.


A step-by-step optimized method of interfascial dissection to avoid three main esthetic complications of the pterional approach—upper facial nerve palsy, temporal muscle atrophy, and retro-orbital depression. A video of the interfascial dissection and three artistic drawings are provided in support of this technique.


A safe method of interfascial dissection, respecting anatomy, and avoiding cosmetic complications has been proposed.


Pterional approach Cosmetic complications Interfascial dissection Temporal muscle dissection Facial nerve 



Galea aponeurotica


Loose areolar tissue


Superior temporal line


Temporal fascia


Temporoparietal fascia


Temporal muscle


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Neurosurgery, La Timone Hospital, APHMAix Marseille UniversityMarseilleFrance
  2. 2.Department of Neurosurgery, CHU AngersUniversity of AngersAngersFrance
  3. 3.Laboratory of AnatomyFaculté de Médecine d’AngersAngersFrance

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