A Consideration of Optimal Head Position in Transsylvian Selective Amygdalohippocampectomy
Transsylvian selective amygdalohippocampectomy (TSA) is one of the predominant surgical options for drug-resistant mesial temporal lobe epilepsy. The purpose of this article is to highlight the unique features of TSA and determine the setting to perform safe and secure TSA with special reference to...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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The Japan Neurosurgical Society
2023-07-01
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| Series: | Neurologia Medico-Chirurgica |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/nmc/63/7/63_2022-0283/_pdf/-char/en |
| _version_ | 1797749479414169600 |
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| author | Tadashi HAMASAKI Hiroki UCHIKAWA Tatsuya KAWANO Keitaro KAI Tastuya TAKEZAKI Akitake MUKASA |
| author_facet | Tadashi HAMASAKI Hiroki UCHIKAWA Tatsuya KAWANO Keitaro KAI Tastuya TAKEZAKI Akitake MUKASA |
| author_sort | Tadashi HAMASAKI |
| collection | DOAJ |
| description | Transsylvian selective amygdalohippocampectomy (TSA) is one of the predominant surgical options for drug-resistant mesial temporal lobe epilepsy. The purpose of this article is to highlight the unique features of TSA and determine the setting to perform safe and secure TSA with special reference to the optimal head position. TSA should be performed via a small surgical corridor in the temporal stem that contains functionally important fiber tracts, including the uncinate fasciculus, the inferior fronto-occipital fasciculus, and the optic radiation. Graphical simulations proposed that low-degree (<30°) head rotation had the advantage of sufficiently opening the surgical field in TSA and may help surgical procedures within the limited exposure of the medial temporal structures. Inspection of the surgical videos implied that the collapse of the inferior horn was prevented in low-degree rotation, probably because the deformation due to the brain shift was minimized in the medial temporal structures. A simulation also implied that chin-up position had the advantage of resecting the tail of the hippocampus in a straightforward manner. We suggest that the setting is optimized in TSA with low-degree rotation and chin-up head position. |
| first_indexed | 2024-03-12T16:19:38Z |
| format | Article |
| id | doaj.art-98f47dd6c7624cf3b9c04f2418df4e7b |
| institution | Directory Open Access Journal |
| issn | 1349-8029 |
| language | English |
| last_indexed | 2024-03-12T16:19:38Z |
| publishDate | 2023-07-01 |
| publisher | The Japan Neurosurgical Society |
| record_format | Article |
| series | Neurologia Medico-Chirurgica |
| spelling | doaj.art-98f47dd6c7624cf3b9c04f2418df4e7b2023-08-08T23:34:16ZengThe Japan Neurosurgical SocietyNeurologia Medico-Chirurgica1349-80292023-07-0163726527210.2176/jns-nmc.2022-02832022-0283A Consideration of Optimal Head Position in Transsylvian Selective AmygdalohippocampectomyTadashi HAMASAKI0Hiroki UCHIKAWA1Tatsuya KAWANO2Keitaro KAI3Tastuya TAKEZAKI4Akitake MUKASA5Department of Neurosurgery, Kumamoto University HospitalDepartment of Neurosurgery, Kumamoto University HospitalDepartment of Neurosurgery, Kumamoto University HospitalDepartment of Neurosurgery, Kumamoto University HospitalDepartment of Neurosurgery, Kumamoto University HospitalDepartment of Neurosurgery, Kumamoto University HospitalTranssylvian selective amygdalohippocampectomy (TSA) is one of the predominant surgical options for drug-resistant mesial temporal lobe epilepsy. The purpose of this article is to highlight the unique features of TSA and determine the setting to perform safe and secure TSA with special reference to the optimal head position. TSA should be performed via a small surgical corridor in the temporal stem that contains functionally important fiber tracts, including the uncinate fasciculus, the inferior fronto-occipital fasciculus, and the optic radiation. Graphical simulations proposed that low-degree (<30°) head rotation had the advantage of sufficiently opening the surgical field in TSA and may help surgical procedures within the limited exposure of the medial temporal structures. Inspection of the surgical videos implied that the collapse of the inferior horn was prevented in low-degree rotation, probably because the deformation due to the brain shift was minimized in the medial temporal structures. A simulation also implied that chin-up position had the advantage of resecting the tail of the hippocampus in a straightforward manner. We suggest that the setting is optimized in TSA with low-degree rotation and chin-up head position.https://www.jstage.jst.go.jp/article/nmc/63/7/63_2022-0283/_pdf/-char/enamygdalohippocampectomyanterior temporal lobectomyhead positionlateral ventriclemesial temporal lobe epilepsy |
| spellingShingle | Tadashi HAMASAKI Hiroki UCHIKAWA Tatsuya KAWANO Keitaro KAI Tastuya TAKEZAKI Akitake MUKASA A Consideration of Optimal Head Position in Transsylvian Selective Amygdalohippocampectomy Neurologia Medico-Chirurgica amygdalohippocampectomy anterior temporal lobectomy head position lateral ventricle mesial temporal lobe epilepsy |
| title | A Consideration of Optimal Head Position in Transsylvian Selective Amygdalohippocampectomy |
| title_full | A Consideration of Optimal Head Position in Transsylvian Selective Amygdalohippocampectomy |
| title_fullStr | A Consideration of Optimal Head Position in Transsylvian Selective Amygdalohippocampectomy |
| title_full_unstemmed | A Consideration of Optimal Head Position in Transsylvian Selective Amygdalohippocampectomy |
| title_short | A Consideration of Optimal Head Position in Transsylvian Selective Amygdalohippocampectomy |
| title_sort | consideration of optimal head position in transsylvian selective amygdalohippocampectomy |
| topic | amygdalohippocampectomy anterior temporal lobectomy head position lateral ventricle mesial temporal lobe epilepsy |
| url | https://www.jstage.jst.go.jp/article/nmc/63/7/63_2022-0283/_pdf/-char/en |
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