Endoscopic and Gravity-Assisted Resection of Medial Temporo-occipital Lesions Through a Supracerebellar Transtentorial Approach: Technical Notes With Case Illustrations

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dc.contributor.authorVillanueva, Pablo
dc.contributor.authorLouis, Robert G.
dc.contributor.authorCutler, Aaron R.
dc.contributor.authorWei, Hua
dc.contributor.authorSale, Danjuma
dc.contributor.authorDuong, Huy T.
dc.contributor.authorBarkhoudarian, Garni
dc.contributor.authorKelly, Daniel F.
dc.date.accessioned2025-01-23T21:33:09Z
dc.date.available2025-01-23T21:33:09Z
dc.date.issued2015
dc.description.abstractBACKGROUND: Traditional approaches to medial temporo-occipital Intra-axial brain tumors carry the risk of visual or language deficits related to brain retraction or transgression of deep fiber tracts. To reduce these risks, the microscopic supracerebellar transtentorial approach with the patient in the sitting position has been previously described for lesions in relative proximity to the tentorium.
dc.description.abstractOBJECTIVE: We describe this approach performed with endoscopic tumor resection to allow better visualization and a more ergonomic operating position.
dc.description.abstractMETHODS: Four consecutive patients harboring a medial temporo-occipital lesion are reported. All were operated on while in the sitting position using frameless navigation and a supracerebellar transtentorial approach. Tumor resection was performed by 2 surgeons with endoscopic visualization.
dc.description.abstractRESULTS: Pathologies included intraparenchymal metastatic melanoma, cavernous hemangioma, and ganglioglioma, as well as an intraventricular metastatic tumor. The distance from the tentorium to the lesion ranged from 1 to 4 mm. Gross total resection was achieved in 3 of the 4 patients. The patient with a metastatic melanoma had an intentional near-total resection given the tumor encasing a branch of the posterior cerebral artery. The patient with the intraventricular tumor sustained a small but symptomatic infarct of the lateral geniculate region, resulting in a visual field deficit.
dc.description.abstractCONCLUSION: This small series suggests that the endoscopic supracerebellar transtentorial approach with the patient in the sitting position can be a safe and effective approach for removing medial temporo-occipital lesions. It allows excellent tumor visualization, eliminates the need for brain retraction, minimizes parenchymal transgression, and improves surgical ergonomics. Significant experience in endoscopy and excellent neuroanesthesia support are recommended before undertaking this approach.
dc.fuente.origenWOS
dc.identifier.doi10.1227/NEU.0000000000000970
dc.identifier.eissn2332-4260
dc.identifier.issn2332-4252
dc.identifier.urihttps://doi.org/10.1227/NEU.0000000000000970
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/101509
dc.identifier.wosidWOS:000365143300001
dc.issue.numero4
dc.language.isoen
dc.pagina.final483
dc.pagina.inicio475
dc.revistaOperative neurosurgery
dc.rightsacceso restringido
dc.subjectEndoscopy
dc.subjectMedial occipital lobe
dc.subjectMedial temporal lobe
dc.subjectSitting position
dc.subjectTranstentorial craniotomy
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleEndoscopic and Gravity-Assisted Resection of Medial Temporo-occipital Lesions Through a Supracerebellar Transtentorial Approach: Technical Notes With Case Illustrations
dc.typeartículo
dc.volumen11
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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