The importance of preoperative planning to perform safely temporal lobe surgery


Atar M., KIZMAZOĞLU C., Kaya I., Cingoz I. D., Uzunoglu I., KALEMCİ O., ...Daha Fazla

JOURNAL OF CLINICAL NEUROSCIENCE, cilt.93, ss.61-69, 2021 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 93
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1016/j.jocn.2021.09.007
  • Dergi Adı: JOURNAL OF CLINICAL NEUROSCIENCE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.61-69
  • Anahtar Kelimeler: Temporal stem, White matter pathways, Fiber dissection, Temporal lobe, DIFFUSION TENSOR TRACTOGRAPHY, VISUAL-FIELD DEFICITS, WHITE-MATTER, SELECTIVE AMYGDALOHIPPOCAMPECTOMY, FUNCTIONAL CONNECTIVITY, ANATOMIC DISSECTION, ANTERIOR COMMISSURE, CORPUS-CALLOSUM, MEYER LOOP, EPILEPSY
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Neurosurgeons should know the anatomy required for safe temporal lobe surgery approaches. The pre-sent study aimed to determine the angles and distances necessary to reach the temporal stem and tem-poral horn in surgical approaches for safe temporal lobe surgery by using a 3.0 T magnetic resonance imaging technique in post-mortem human brain hemispheres fixed by the Klingler method. In our study, 10 post-mortem human brain hemisphere specimens were fixed according to the Klingler method. Magnetic resonance images were obtained using a 3.0 T magnetic resonance imaging scanner after fixa-tion. Surgical measurements were conducted for the temporal stem and temporal horn by magnetic res-onance imaging, and dissection was then performed under a surgical microscope for the temporal stem. Each stage of dissection was achieved in high-quality three-dimensional images. The angles and distances to reach the temporal stem and temporal horn were measured in transcortical T1, trans-sulcal T1-2, transcortical T2, trans-sulcal T2-3, transcortical T3, and subtemporal trans-collateral sulcus approaches. The safe maximum posterior entry point for anterior temporal lobectomy was measured as 47.16 +/- 5.0 0 mm. Major white-matter fibers in this region and their relations with each other are shown. The dis-tances to the temporal stem and temporal horn, which are important in temporal lobe surgical interven-tions, were measured radiologically, and safe borders were determined. Surgical strategy and preoperative planning should consider the relationship of the lesion and white-matter pathways. (c) 2021 Elsevier Ltd. All rights reserved.