Shunt, endoscopic, and microsurgical management of trapped temporal horn following resection of lateral ventricle trigonal or peritrigonal tumors: A retrospective multicenter study.

OBJECTIVE

To investigate the surgical management and outcomes of trapped temporal horn (TTH) following resection of lateral ventricle trigonal or peritrigonal tumors.

METHODS

Patients who underwent surgical treatment for TTH in three different tertiary centers between 2012 and 2022 were retrospectively studied. The primary outcome was reoperation rate.

RESULTS

Thirty-one patients were included for analysis. The underlying pathology was meningioma in 17 patients, central neurocytoma in 7, glioma in 4, ependymoma in 2, and cavernous malformation in 1. The median KPS score was 50 (range 10-90) and the mean volume of TTH was 53.1 ± 29.9 cm³ (range 14.8-118.6). Six patients (19.3 %) required multiple operations. A total of 39 procedures were performed, including 28 CSF shunting, 2 endoscopic septostomy, 3 microsurgical fenestration or temporal tip lobectomy via craniotomy, 2 decompressive craniectomy (DC), and 4 shunt revisions. Reoperation rates according to procedure were as follows: 10.7 % (3/28) for CSF shunting, 50 % (1/2) for endoscopic septostomy, 100 % (2/2) for DC, and 0 (0/3) for microsurgical fenestration or temporal tip lobectomy. CSF shunting tended to have a lower reoperation rate compared to other surgical approaches (p = 0.079). The reoperation rate was significantly higher for DC than for other surgical techniques (p = 0.025).

CONCLUSION

CSF shunting was the most frequently used technique with a relatively low revision rate. Long-term patency can be achieved through endoscopic septostomy in selected patients. Microsurgical fenestration or temporal tip lobectomy should be reserved for refractory cases. DC has limited effectiveness and should not be recommended.