Endoscopic supracerebellar transtentorial approach for amygdalohippocampectomy (ESTAH): an anatomic study of the minimally invasive keyhole technique
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Le résumé fourni par la source
OBJECTIVE: The mediobasal temporal region (MTR) is a complex neurosurgical target due to its deep location and proximity to critical neurovascular structures. Conditions such as mesial temporal sclerosis frequently involve the MTR, often leading to epilepsy. Traditional approaches, including anterior lobectomy and transcortical amygdalohippocampectomy, are effective but carry risks such as visual field deficits from optic radiation damage. This study evaluates the feasibility and effectiveness of the endoscopic supracerebellar transtentorial approach (ESTAH) as a minimally invasive alternative, emphasizing neurovascular preservation and minimizing complications. METHODS: Four formalin-fixed, silicon-injected cadaver heads and ten human cadaver brains prepared using the Klingler method were dissected to study MTR anatomy. ESTAH was performed using 0° and 30° endoscopes and neuronavigation. Key anatomical landmarks, including the tentorial angle and the posterior fossa dura-to-hippocampal uncus distance, were measured to assess surgical precision and safety. RESULTS: The endoscope provided precise visualization and resection of the hippocampus, amygdala, and parahippocampal gyrus with minimal disruption to optic radiations and adjacent white matter tracts. Critical neurovascular structures, such as the internal carotid artery, middle cerebral artery branches, posterior cerebral artery, and cranial nerves III and IV, were preserved. The average dura-to-uncus distance was 78.15 mm, and the average tentorial angle was 104.1°. CONCLUSION: The ESTAH is a feasible, minimally invasive alternative for amygdalohippocampectomy, offering excellent visualization and reduced risk of complications. This approach has the potential to improve surgical outcomes and minimize morbidity in MTR surgeries.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Endoscopic supracerebellar transtentorial approach for amygdalohippocampectomy (ESTAH): an anatomic study of the minimally invasive keyhole technique
- Date Crossref
- 16/04/2025
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Cleveland Clinic Florida Department of Neurological Surgery pays non établi dans la noticeÉtablissement de santé
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Neurological Surgery pays non établi dans la noticeÉtablissement de santé
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University of Alabama at Birmingham Department of Neurosurgery pays non établi dans la noticeUniversité ou école supérieure
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Allegheny General Hospital Department of Neurosurgery pays non établi dans la noticeÉtablissement de santé
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King Saud University Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
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Nova Southeastern University pays non établi dans la noticeUniversité ou école supérieure
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Dr. Kiran C. Patel College of Allopathic Medicine pays non établi dans la noticeUniversité ou école supérieure
Department of Neurological Surgery — Cleveland Clinic Florida, Neurological Surgery et Department of Neurosurgery — University of Alabama at Birmingham, avec 4 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.