Transtemporal-transchoroidal approach and its transamygdala extension to the posterior chiasmatic cistern and diencephalo-mesencephalic lesions
| Autor: | C. Haegelen, Abderrahmane Hamlat, H. Helal, L. Riffaud, Xavier Morandi, Gilles Brassier, Béatrice Carsin-Nicol |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male Microsurgery medicine.medical_specialty Hamartoma Astrocytoma Chiasmatic cistern Ventriculoperitoneal Shunt Craniopharyngioma Hypothalamic hamartoma Mesencephalon medicine Humans Pituitary Neoplasms Diencephalon Child Aged Neuroradiology Pilocytic astrocytoma medicine.diagnostic_test Brain Neoplasms business.industry Magnetic resonance imaging Interventional radiology Middle Aged Amygdala medicine.disease Magnetic Resonance Imaging Temporal Lobe Choroidal fissure Surgery Child Preschool Optic Chiasm Choroid Plexus Female Neurology (clinical) Neurosurgery Hypothalamic Neoplasms Tomography X-Ray Computed business Hydrocephalus |
| Zdroj: | Acta Neurochirurgica. 150:317-328 |
| ISSN: | 0942-0940 0001-6268 |
| Popis: | The aim of this report is to illustrate the successful surgical management of five patients with suprasellar retrochiasmatic and diencephalo-mesencephalic tumours, using a trans-amygdala extension of the trans-temporal/trans-choroidal fissure approach. The procedure is described for five surgically treated patients with such lesions that includes three retrochiasmatic craniopharyngiomas, one hypothalamic hamartoma, and one pilocytic astrocytoma in the left crus cerebri. The management procedure included computed tomography scan (CT scan) and magnetic resonance imaging (MRI). The trans-temporal/trans-choroidal fissure approach enabled us to perform total tumour resection in four patients and a subtotal resection in one. Some technical aspects and pitfalls of the procedure are discussed. This method creates optimum conditions for a radical excision of various suprasellar retrochiasmatic and diencephalo-mesencephalic tumours without mortality and only minimum morbidity. However, no single surgical approach can provide access to the entire variety of tumours located in the suprasellar retrochiasmatic and diencephalo-mesencepalic region. Surgical approaches must be tailored to the site, type of lesion, and its extensions. This method is only another surgical option. Its successful use requires a familiarity with the anatomy of these regions and an understanding of its specificity for a radical excision of some selected tumours, as well as its limitations to access others types of lesions. Although, it seems effective, this approach needs to be evaluated by further experience, owing to the small number of patients reported in this series. |
| Databáze: | OpenAIRE |
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