Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes
Hypothalamic hamartoma (HH) is a rare lesion consisting of normal neurons and neuroglia arranged in an abnormal pattern which usually causes gelastic seizures (GS). Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has been developed as a minimally invasive approach to treat HH...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-11-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/11/21/6579 |
| _version_ | 1797467703640850432 |
|---|---|
| author | Yuan Yao Xiu Wang Wenhan Hu Chao Zhang Lin Sang Zhong Zheng Jiajie Mo Chang Liu Jiaji Qiu Xiaoqiu Shao Jianguo Zhang Kai Zhang |
| author_facet | Yuan Yao Xiu Wang Wenhan Hu Chao Zhang Lin Sang Zhong Zheng Jiajie Mo Chang Liu Jiaji Qiu Xiaoqiu Shao Jianguo Zhang Kai Zhang |
| author_sort | Yuan Yao |
| collection | DOAJ |
| description | Hypothalamic hamartoma (HH) is a rare lesion consisting of normal neurons and neuroglia arranged in an abnormal pattern which usually causes gelastic seizures (GS). Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has been developed as a minimally invasive approach to treat HH and gradually become a first-line treatment. In total, this study enrolled 47 consecutive HH patients that underwent one round of ablation. Patients were followed for at least one year. Patients’ medical records and surgical information were carefully reviewed, and univariate analyses were performed. Of the treated patients, 72.3% remained GS-free in this study, with an overall Engel class I rate of 68.1%. Long-term postoperative complications occurred in six patients. Factors associated with GS prognosis included Delalande classification (<i>p</i> = 0.033), HH volume (<i>p</i> = 0.01), and the ablation rate of the HH body (<i>p</i> = 0.035). The disconnection rate was 0.73 ± 0.14 in the Engel class Ia group as compared to 0.62 ± 0.13 in the Engel Ib–Engel IV group (<i>p</i> = 0.046). MRgLITT represents a safe and effective surgical procedure. Patients with larger or Delalande type IV HH may require multiple rounds of ablation. In addition to assessing the degree of disconnection, ablation volume should also be carefully considered for patients undergoing this procedure. |
| first_indexed | 2024-03-09T18:57:28Z |
| format | Article |
| id | doaj.art-34f3161af0314d299fc96e53a0c89173 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T18:57:28Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-34f3161af0314d299fc96e53a0c891732023-11-24T05:19:59ZengMDPI AGJournal of Clinical Medicine2077-03832022-11-011121657910.3390/jcm11216579Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment OutcomesYuan Yao0Xiu Wang1Wenhan Hu2Chao Zhang3Lin Sang4Zhong Zheng5Jiajie Mo6Chang Liu7Jiaji Qiu8Xiaoqiu Shao9Jianguo Zhang10Kai Zhang11Department of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing 100070, ChinaDepartment of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing 100070, ChinaBeijing Neurosurgical Institute, Capital Medical University, Beijing 100070, ChinaDepartment of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing 100070, ChinaDepartment of Neurosurgery, Beijing FengTai Hospital, Beijing 100070, ChinaDepartment of Neurosurgery, Beijing FengTai Hospital, Beijing 100070, ChinaDepartment of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing 100070, ChinaDepartment of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing 100070, ChinaDepartment of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing 100070, ChinaDepartment of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing 100070, ChinaDepartment of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing 100070, ChinaDepartment of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing 100070, ChinaHypothalamic hamartoma (HH) is a rare lesion consisting of normal neurons and neuroglia arranged in an abnormal pattern which usually causes gelastic seizures (GS). Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has been developed as a minimally invasive approach to treat HH and gradually become a first-line treatment. In total, this study enrolled 47 consecutive HH patients that underwent one round of ablation. Patients were followed for at least one year. Patients’ medical records and surgical information were carefully reviewed, and univariate analyses were performed. Of the treated patients, 72.3% remained GS-free in this study, with an overall Engel class I rate of 68.1%. Long-term postoperative complications occurred in six patients. Factors associated with GS prognosis included Delalande classification (<i>p</i> = 0.033), HH volume (<i>p</i> = 0.01), and the ablation rate of the HH body (<i>p</i> = 0.035). The disconnection rate was 0.73 ± 0.14 in the Engel class Ia group as compared to 0.62 ± 0.13 in the Engel Ib–Engel IV group (<i>p</i> = 0.046). MRgLITT represents a safe and effective surgical procedure. Patients with larger or Delalande type IV HH may require multiple rounds of ablation. In addition to assessing the degree of disconnection, ablation volume should also be carefully considered for patients undergoing this procedure.https://www.mdpi.com/2077-0383/11/21/6579hypothalamic hamartomaMRgLITTgelastic seizures |
| spellingShingle | Yuan Yao Xiu Wang Wenhan Hu Chao Zhang Lin Sang Zhong Zheng Jiajie Mo Chang Liu Jiaji Qiu Xiaoqiu Shao Jianguo Zhang Kai Zhang Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes Journal of Clinical Medicine hypothalamic hamartoma MRgLITT gelastic seizures |
| title | Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes |
| title_full | Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes |
| title_fullStr | Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes |
| title_full_unstemmed | Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes |
| title_short | Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes |
| title_sort | magnetic resonance guided laser interstitial thermal therapy for hypothalamic hamartoma surgical approach and treatment outcomes |
| topic | hypothalamic hamartoma MRgLITT gelastic seizures |
| url | https://www.mdpi.com/2077-0383/11/21/6579 |
| work_keys_str_mv | AT yuanyao magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT xiuwang magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT wenhanhu magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT chaozhang magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT linsang magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT zhongzheng magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT jiajiemo magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT changliu magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT jiajiqiu magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT xiaoqiushao magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT jianguozhang magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes AT kaizhang magneticresonanceguidedlaserinterstitialthermaltherapyforhypothalamichamartomasurgicalapproachandtreatmentoutcomes |