Abstract：
: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.
journal_name
Neurosurg Revjournal_title
Neurosurgical reviewauthors
Yang PF,Zhang HJ,Pei JS,Lin Q,Mei Z,Chen ZQ,Jia YZ,Zhong ZH,Zheng ZYdoi
10.1007/s10143-015-0657-8subject
Has Abstractpub_date
2016-01-01 00:00:00pages
99-108; discussion 108issue
1eissn
0344-5607issn
1437-2320pii
10.1007/s10143-015-0657-8journal_volume
39pub_type
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