前颞叶切除术
Anterior temporal lobectomy.
作者信息
Schaller Karl, Cabrilo Ivan
机构信息
Neurosurgery Division, Department of Clinical Neurosciences, Faculty of Medicine, Geneva University Medical Center, Geneva, Switzerland.
Neurosurgery Division, Department of Clinical Neurosciences, Geneva University Hospitals (Hôpitaux Universitaires de Genève), Rue Gabrielle-Perret-Gentil 4, 1211, Genève 14, Switzerland.
出版信息
Acta Neurochir (Wien). 2016 Jan;158(1):161-6. doi: 10.1007/s00701-015-2640-0. Epub 2015 Nov 23.
BACKGROUND
Anterior temporal lobectomy is the most established neurosurgical procedure for temporal lobe epilepsy. Here we describe this technique.
METHOD
A temporal craniotomy is performed flush with the middle fossa and exposing the Sylvian fissure. The posterior extent of resection is determined as 4.5 cm in the dominant temporal lobe and 5.5 cm in the nondominant one. The first stage consists of removing the lateral neocortex and part of the fusiform gyrus, parallel to the Sylvian fissure, while keeping the temporal horn as the medial limit in the coronal plane. Then, the amygdala, uncus, fimbriae, hippocampus and collateral eminence are identified, transected and resected with the parahippocampal gyrus to complete the procedure.
CONCLUSION
Knowledge of the temporomesial anatomy, including neurovascular structures around the brainstem, is essential to keep this procedure safe and effective.
背景
颞叶前部切除术是治疗颞叶癫痫最成熟的神经外科手术。在此我们描述该技术。
方法
进行颞骨开颅术，与中颅窝齐平并暴露外侧裂。在优势颞叶，切除范围的后界确定为4.5厘米，在非优势颞叶为5.5厘米。第一阶段包括平行于外侧裂切除外侧新皮质和部分梭状回，在冠状面以颞角作为内侧界限。然后，识别杏仁核、钩回、伞、海马和侧副隆起，横断并与海马旁回一并切除以完成手术。
结论
了解颞叶内侧解剖结构，包括脑干周围的神经血管结构，对于确保该手术的安全和有效至关重要。
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