Microneurosurgical Anatomic Study of the Horizontal Fissure of the Cerebellum

-OBJECTIVE: The horizontal fissure of the cerebellum, which is the largest , most prominent fissure, has received less interest from anatomists and neurosurgeons. Hence, the current study aims to provide comprehensive detail about the horizontal fissure and its anatomic and surgical relationship with deeper structures such as the dentate nucleus and middle cerebellar peduncle for the benefit of the neurosurgeon.-METHODS: Ten whole formalin-fixed human cadaveric cerebellar hemispheres were obtained from human ca-davers donated to the institution. Different parameters of the horizontal fissure were studied, such as length, depth (medial end, lateral end , middle), sulcal and gyral variations (superficial and deep), and its close relationship, especially at depth, with the dentate nucleus and middle cerebellar peduncle.-RESULTS: The total length of the horizontal fissure on the right and the left side was 64.3 + 7.9 mm (range, 53-77 mm) and 65.6 + 8.01 mm (range, 53-79 mm), respectively. The medial third of the horizontal fissure, with the fewest vessels, was the most suitable place to puncture or start the dissection of the horizontal fissure. The surface pro-jection of the center of the posterior border of the dentate -ucleus lies within 20-21 mm on either side of the pos-terior midline along the horizontal fissure and is only approximately 4 mm deep from the horizontal fissure.-CONCLUSIONS: The anatomic measurements and re-lationships provided in this description of the horizontal fissure will serve as a tool for surgery selection and planning, as well as an aid to improve microneurosurgical techniques, with the final goal being better patient outcomes.

Automated summary

This study aims to provide comprehensive detail about the horizontal fissure and its relationship with deeper structures such as the dentate nucleus and middle cerebellar peduncle, for the benefit of neurosurgeons. The length and depth of the horizontal fissure were studied, and it was found that the medial third of the fissure is the most suitable place for puncture or dissection. The relationship between the dentate nucleus and the horizontal fissure was also discussed.