Inoue Hirotaka, Kuroda Jun-Ichiro, Hamasaki Tadashi, Mukasa Akitake
Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, Japan.
Department of Neurosurgery, Graduate School of Medicine, University of the Ryukyus, Ginowan, Japan.
Surg Neurol Int. 2025 Jul 11;16:285. doi: 10.25259/SNI_307_2025. eCollection 2025.
The anterior choroidal artery and lateral posterior choroidal artery are vital structures preserved during the microsurgical treatment of glioblastomas in the temporal lobe. Nevertheless, few studies have examined the appropriate head position for identifying the choroidal arteries in resecting such glioblastomas. In general, a 45°-90° rotation to the opposite side of the lesion is commonly used; however, we have utilized a low-degree rotation (LDR) and chin-up (CU) head position.
The LDR is 30-40° rotation to the opposite side of the lesion. The CU is the angle at which the line connecting the nasion and inion is tilted approximately 30° from the vertical. We retrospectively assessed six consecutive patients with glioblastomas extending into the medial part of the temporal lobe that was resected using the LDR and CU.
None of our six patients had an infarction in the area of the choroidal artery or any surgery-related adverse symptoms. The choroidal arteries and hippocampus were not at the deepest point of the resection cavity in the LDR and CU; therefore, these structures were identified during the early phase of surgery.
We suggest that the LDR and CU are suitable for resecting glioblastomas extending into the medial part of the temporal lobe.
脉络膜前动脉和脉络膜后外侧动脉是颞叶胶质母细胞瘤显微手术治疗中需要保留的重要结构。然而，很少有研究探讨在切除此类胶质母细胞瘤时识别脉络膜动脉的合适头部位置。一般来说，通常采用向病变对侧旋转45°-90°；然而，我们采用了低度旋转（LDR）和抬头（CU）的头部位置。
LDR是向病变对侧旋转30-40°。CU是连接鼻根和枕外隆凸的线与垂直线倾斜约30°的角度。我们回顾性评估了连续6例胶质母细胞瘤延伸至颞叶内侧部分并采用LDR和CU进行切除的患者。
我们的6例患者中，没有1例在脉络膜动脉区域发生梗死或出现任何与手术相关的不良症状。在LDR和CU中，脉络膜动脉和海马体不在切除腔的最深点；因此，这些结构在手术早期就被识别出来。
我们认为LDR和CU适用于切除延伸至颞叶内侧部分的胶质母细胞瘤。
