Keyhole epilepsy surgery: corticoamygdalohippocampectomy for mesial temporal sclerosis

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• 作者：Peng-Fan Yang ; Hui-Jian Zhang ; Jia-Sheng Pei ; Qiao Lin ; Zhen Mei…
• 关键词：Mesial temporal lobe epilepsy ; Hippocampal sclerosis ; Keyhole craniotomy ; Corticoamygdalohippocampectomy ; Seizure outcome
• 刊名：Neurosurgical Review
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：39
• 期：1
• 页码：99-108
• 全文大小：2,175 KB
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• 作者单位：Peng-Fan Yang (1)
  Hui-Jian Zhang (1)
  Jia-Sheng Pei (1)
  Qiao Lin (2)
  Zhen Mei (2)
  Zi-Qian Chen (3)
  Yan-Zeng Jia (2)
  Zhong-Hui Zhong (2)
  Zhi-Yong Zheng (4)
  
  1. Department of Neurosurgery, Fuzhou General Hospital of Nanjing Command, PLA, North Road 156, West, Second Ring, Fuzhou, 350025, China
  2. Department of Epileptology, Fuzhou General Hospital of Nanjing Command, PLA, Fuzhou, 350025, China
  3. Department of Medical Imaging, Fuzhou General Hospital of Nanjing Command, PLA, Fuzhou, 350025, China
  4. Department of Pathology, Fuzhou General Hospital of Nanjing Command, PLA, Fuzhou, 350025, China
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Neurosurgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1437-2320

文摘

Surgical approaches for medically refractory mesial temporal lobe epilepsy (MTLE) that previously have been reported include anterior temporal lobectomy (ATL), transcortical selective amygdalohippocampectomy, transsylvian amygdalohippocampectomy, and subtemporal amygdalohippocampectomy. Each approach has its advantages and potential pitfalls. The purpose of this report is to describe our technique of keyhole corticoamygdalohippocampectomy for patients with MTLE due to hippocampal sclerosis. Operations were performed through a 6-cm vertical linear incision and a low 2.5-cm keyhole craniotomy at the anterior squamous temporal bone. Resection of the anterior-most portions of the middle and inferior temporal gyri provided a cylinder-like corridor to the mesial temporal lobe. Identification of the temporal horn through a basal approach was followed by resection of the amygdala, uncus, and hippocampus-parahippocampal gyrus. This 9-year series included 683 patients with a minimum follow-up duration of 2 years. Surgery times were short (range, 1 h 35 min to 2 h 30 min). Only a small percentage of patients had complications (1.76 %), and the rate of Engel Class I seizure-free outcome was 87 %. No overt speech problems or visual field deficits were identified. Compared with the most popular conventional trans-middle temporal gyrus approach, this technique can make the operation easier, safer, and less traumatic to functional lateral neocortex. Keywords Mesial temporal lobe epilepsy Hippocampal sclerosis Keyhole craniotomy Corticoamygdalohippocampectomy Seizure outcome