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Acta Neurochirurgica

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01-11-2015 | How I Do it - Brain Tumors

Minimally invasive subfrontal route for the resection of medial temporal region intrinsic tumors

Authors: Giannantonio Spena, Pier Paolo Panciani, Federico Nicolosi, Marco Fontanella

Published in: Acta Neurochirurgica | Issue 11/2015

Abstract

Background

The mesial temporal region (MTR) comprises important components of the limbic system, as well as vital neurovascular structures. Because of its important functional role, as much healthy brain tissue as possible must be preserved while targeting resection of MTR lesions.

Methods

A frontal minicraniotomy is used to access the MTR through a subfrontal approach. By opening the most medial part of the Sylvian fissure, the uncus-amygdala complex is exposed, and through this, the head of the hippocampus can be reached and removed as well.

Conclusions

This approach is extremely suitable for MTR lesions, as it provides the advantage of sparing the most important functional structures of the temporal lobe, the temporal stem, and the limen insulae, as well as the optic radiations and the fronto-occipital connections.

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Gazzeri R, Nishiyama Y, Teo C (2014) Endoscopic supraorbital eyebrow approach for the surgical treatment of extraaxial and intraaxial tumors. Neurosurg Focus 37(4):E20. doi:10.3171/2014.7.FOCUS14203 CrossRefPubMed

Georgiadis I, Kapsalaki EZ, Fountas KN (2013) Temporal lobe resective surgery for medically intractable epilepsy: a review of complications and side effects. Epilepsy Res Treat 752195. doi:10.1155/2013/752195

Kier EL, Staib LH, Davis LM, Bronen RA (2004) MR imaging of the temporal stem: anatomic dissection tractography of the uncinate fasciculus, inferior occipitofrontal fasciculus, and Meyer's loop of the optic radiation. Am J Neuroradiol 25(5):677–691PubMed

Martens T, Merkel M, Holst B, Brückner K, Lindenau M, Stodieck S, Fiehler J, Westphal M, Heese O (2014) Vascular events after transsylvian selective amygdalohippocampectomy and impact on epilepsy outcome. Epilepsia 55(5):763–769. doi:10.1111/epi.12556 CrossRefPubMed

Martino J, Vergani F, Robles SG, Duffau H (2010) New insights into the anatomic dissection of the temporal stem with special emphasis on the inferior fronto-occipital fasciculus: implications in surgical approach to left mesiotemporal and temporoinsular structures. Neurosurgery 66(3 Suppl Operative):4–12PubMed

Phi JH, Chung CK (2009) Brain tumors in the mesial temporal lobe: long-term oncological outcome. Neurosurg Focus 27(2):E5. doi:10.3171/2009.5.FOCUS09106 CrossRefPubMed

Reisch R, Stadie A, Kockro R, Gawish I, Schwandt E, Hopf N (2009) The minimally invasive supraorbital subfrontal key-hole approach for surgical treatment of temporomesial lesions of the dominant hemisphere. Minim Invasive Neurosurg 52(4):163–169CrossRefPubMed

Schramm J, Aliashkevich AF (2007) Surgery for temporal mediobasal tumors: experience based on a series of 235 patients. Neurosurgery 60(2):285–294CrossRefPubMed

Spena G, Versari P (2011) Bubbles in the head: a new method for brain retraction during craniotomy. Acta Neurochir 153(9):1807–1811CrossRefPubMed

Title: Minimally invasive subfrontal route for the resection of medial temporal region intrinsic tumors
Authors: Giannantonio Spena
Pier Paolo Panciani
Federico Nicolosi
Marco Fontanella
Publication date: 01-11-2015
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 11/2015
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-015-2595-1

At a glance: The STEP trials

Springer Medicine

Minimally invasive subfrontal route for the resection of medial temporal region intrinsic tumors

Abstract

Background

Methods

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Conclusions

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