A stepwise laboratory manual for the dissection and illustration of limbic and paralimbic structures: lessons learned from the Klingler’s technique

• Published in: Surgical and radiologic anatomy (English ed.) 2022-07, Vol.44 (7), p.1045-1061
• Main Authors: Komaitis, Spyridon, Stranjalis, George, Kalamatianos, Theodosis, Drosos, Evangelos, Kalyvas, Aristotelis V., Skandalakis, Georgios P., Liouta, Evangelia, Charalampopoulou, Eirini, Mazarakis, Nektarios, Koutsarnakis, Christos
• Format: Article
• Language: English
• Subjects: Anatomy; Cerebral hemispheres; Dissection; Imaging; Laboratories; Medicine; Medicine & Public Health; Neural networks; Orthopedics; Radiology; Surgery; Teaching Anatomy
• ISSN: 1279-8517; 0930-1038; 1279-8517
• DOI: 10.1007/s00276-022-02981-0

Background Three-dimensional relationships within the limbic and paralimbic areas are often hard to grasp. Relevant anatomical structures exhibit a complicated architecture and connectivity and therefore surgical approaches targeting lesions or functional resections in this area pose a distinct challenge. Purpose To provide an educational, comprehensive, systematic and stepwise manual for the dissection and illustration of major limbic structures since there is a gap in the pertinent literature. Further, we aim to offer a thorough yet simplified roadmap for laboratory and intraoperative dissections. Methods Twenty (20) normal adult, formalin-fixed cerebral hemispheres were studied through the fiber dissection technique and under the microscope. Stepwise and in tandem medial to lateral and lateral to medial dissections were performed in all specimens aiming to reveal the morphology and spatial relationships of major limbic and paralimbic areas. Results Fourteen (14) consecutive, discrete and easily reproducible laboratory anatomical steps are systematically described to reveal the intricate anatomy of the limbic and paralimbic structures and their main connections. Conclusion This study offers for the first time in the pertinent literature a focused, step-by-step laboratory manual for the dissection and illustration of the limbic and paralimbic structures. The overreaching goal is to supplement the novice and experienced anatomist and neurosurgeon with a thorough and systematic reference to facilitate laboratory or intraoperative dissections.