Minimally invasive subfrontal route for the resection of medial temporal region intrinsic tumors
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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.
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.
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.
KeywordsMedial temporal region Limbic system Gliomas Uncus Amygdala Minimally invasive
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Authors’ statement of conflict of interest
All Authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria, educational grants, participation in speakers’ bureaus, membership, employment, consultancies, stock ownership or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
In this video a case of low-grade glioma of the medial temporal region is presented. All the surgical steps are shown, starting from the craniotomy, the trajectories and the subpial technique used to remove the tumor. (MP4 215065 kb)
- 2.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
- 5.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):4–12PubMedGoogle Scholar