The operative approach to the posterior incisural space is challenging because of its deep location, the surrounding eloquent areas, and the intimate relationship with the deep veins. Several approaches have been proposed to manage the lesions in this region: supratentorial, infratentorial and a combination of them. Brain retraction, injury to the occipital lobe and corpus callosum, and venous bleeding are the principle drawbacks of these routes. We performed anatomical dissection study using 10 embalmed human cadaver specimens injected with colored latex exploring a different route, parietal interhemispheric transfalcine transtentorial (PITT). Then we used a PITT approach on two patients with posterior incisural space (PIS) lesions. The PITT approach led to successful and safe complete removal of PIS lesions in our cases. No complications were reported. The present approach could be a valuable option in case of PIS lesions, especially those associated with downward displacement of the deep venous complex; thanks to the gravity it reduce the complications related to the occipital lobe retraction and manipulation. Moreover, cutting the superior-anterior edge of the tentorium, the sub-tentorial space could be reached.

后切牙空间的手术方法具有挑战性，因为其位置深，周围的雄辩区域以及与深静脉的亲密关系。已经提出了几种方法来处理该区域的病变：幕上，下肌及其组合。脑退缩，枕叶和体损伤以及静脉出血是这些途径的主要缺点。我们进行了解剖解剖研究，使用了10个涂有彩色乳胶的防腐人体尸体标本，探索了一条不同的途径，即顶叶半球间透膜法（FTT）。然后我们对两名后切牙间隙（PIS）病变的患者使用了PITT方法。PITT方法可成功，安全地彻底清除我们病例中的PIS病变。没有并发症的报道。对于PIS病变，特别是与深静脉复合体向下移位相关的病变，本方法可能是有价值的选择。由于重力的作用，它减少了与枕叶回缩和操作有关的并发症。此外，切开腱鞘的前上边缘，可以到达腱下膜下腔。