2İstanbul Bilim Üniversitesi, Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, İstanbul, Türkiye AIM: This article focuses on the surgical technique and clinical results in patients with mediobasal tumors operated by the epilepsy team of the neurosurgery department of Cerrahpasa Medical Faculty.
MATERIAL and METHODS: Between 1995 and 2014, 591 patients with drug-resistant epilepsy were operated at our clinic. In this patient group, 99 had a tumor located in the mediobasal region. All patients were examined with magnetic resonance imaging and electroencephalography. If findings were inconsistent, invasive monitorization with strip electrodes was performed. The transsylvian route (TS) described by Yasargil for selective amygdalohippocampectomy was the choice of surgical route in most patients, followed by anterior temporal lobectomy (ATL).
RESULTS: The distribution of the patients according to the histological diagnosis was oligodendroglioma in 31 cases, astrocytoma grade II in 22 cases, ganglioglioma in 21 cases, astrocytoma grade I in 13 cases, and DNET in 9 cases. The complications were hemiparesis in 6 cases, third nerve palsy in 4 cases, and osteomyelitis in one patient. A large visual field defect was detected in one patient who underwent extensive temporal resection. No mortality related to surgical treatment was observed in the early postoperative period.
CONCLUSION: From the viewpoint of microsurgical anatomy, TS promotes a safe entry to most of the temporal horn and surrounding structures. Lesions located more posteriorly may need to be accessed via ATL, necessitating resection of the temporal pole and lateral temporal neocortex.
Anahtar Kelimeler : Anterior temporal lobectomy, Drug resistant epilepsy, Low grade glioma, Mediobasal tumor, Microsurgical anatomy, Selective amygdalohippocampectomy