额颞叶切断术：我的操作方法。
Frontal lobe disconnection: How I do it.
机构信息
Department of Neurosurgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan.
出版信息
Acta Neurochir (Wien). 2024 Oct 29;166(1):429. doi: 10.1007/s00701-024-06319-0.
BACKGROUND
The objective of frontal lobe disconnection (FD) is to isolate the frontal lobe without removing brain parenchyma, to achieve epilepsy outcomes comparable to those for frontal lobectomy but with fewer complications, since a large post-operative cavity is not created.
METHOD
Main surgical steps include "Identification of the central sulcus" to ensure the preservation of motor function, and "Frontal lobe disconnection" comprising: 1) fronto-parietal disconnection; 2) fronto-basal disconnection; 3) anterior corpus callosotomy; and 4) insula and basal ganglia disconnection.
CONCLUSION
In performing FD, consideration of the disconnection boundary based on an anatomical understanding of white matter tracts is essential.
背景
额叶离断术（FD）的目的是在不切除脑实质的情况下隔离额叶，以实现与额叶切除术相当的癫痫治疗效果，但并发症更少，因为不会形成大的术后空腔。
方法
主要手术步骤包括“识别中央沟”以确保运动功能的保留，以及“额叶离断”，包括：1）额顶离断；2）额基底离断；3）前部胼胝体切开术；以及 4）岛叶和基底节离断。
结论
在进行 FD 时，必须根据对脑白质束的解剖学理解考虑离断边界。
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