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Supraorbital subfrontal trans-laminar endoscope-assisted approach for tumors of the posterior third ventricle.

Abstract：

BACKGROUND:Different surgical approaches have been developed for dealing with third ventricle lesions, all aimed at obtaining a safe removal minimizing brain manipulation. The supraorbital subfrontal trans-lamina terminalis route, commonly employed only for the anterior third ventricle, could represent, in selected cases with endoscopic assistance, an alternative approach to posterior third ventricular lesions. METHODS:Seven patients underwent a supraorbital subfrontal trans-laminar endoscope-assisted approach to posterior third ventricle tumors (two craniopharyngiomas, one papillary tumor of the pineal region, one pineocytoma, two neurocytomas, one glioblastoma). Moreover, a conventional third ventriculostomy was performed via the same trans-laminar approach in four cases. RESULTS:Complete tumor removal was accomplished in four cases, subtotal removal in two cases, and a simple biopsy in one case. Adjuvant radiotherapy and/or chemotherapy was administered, if required, on the basis of the histologic diagnosis. No major complications occurred after surgery except for an intratumoral hemorrhage in a patient undergoing a biopsy for a glioblastoma, which simply delayed the beginning of adjuvant radiochemotherapy. No ventriculoperitoneal shunt placement was needed in these patients at the most recent clinical and radiologic session (average 39.57 months, range 13-85 months). Two illustrative cases are presented. CONCLUSIONS:The supraorbital subfrontal trans-laminar endoscope-assisted approach may provide, in selected cases, an efficient and safe route for dealing with posterior third ventricular tumors.

journal_name

Acta Neurochir (Wien)

journal_title

Acta neurochirurgica

authors

Iacoangeli M,Colasanti R,Esposito D,Di Rienzo A,di Somma L,Dobran M,Gladi M,Scerrati M

doi

10.1007/s00701-017-3117-0

subject

Has Abstract

pub_date

2017-04-01 00:00:00

pages

645-654

issue

4

eissn

0001-6268

issn

0942-0940

pii

10.1007/s00701-017-3117-0

journal_volume

159

pub_type

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