Endoscopic Transanterior Middle Temporal Approach to the Atrium—An Anatomical Feasibility Study

Lau, Ruth; Rubio, Roberto Rodriguez; Martino, Juan; Sanmillán, José L.; Benet, Arnau; Meybodi, Ali Tayebi; Gandhi, Sirin; Kournoutas, Ioannis; Gabarrós, Andreu

doi:10.1016/j.wneu.2019.04.034

Cited by 4 publications

(3 citation statements)

References 29 publications

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Section: Introductionmentioning

confidence: 99%

“…TMTGA has been previously used for amygdalohippocampectomy 2 and approach to the atrium in the lateral ventricle. 3 The primary purpose of this study was to elucidate the feasibility and limitations of endoscopic TMTGA for putaminal hemorrhage, particularly for those extending into the temporal lobe.…”

Section: Introductionmentioning

confidence: 99%

“…TMTGA has been previously used for amygdalohippocampectomy 2 and approach to the atrium in the lateral ventricle. 3…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic Evacuation of Putaminal Hemorrhage Using the Trans-Middle Temporal Gyrus Approach: Technical Notes and Case Presentations

Yamazaki

Ogiwara

Kitamura

et al. 2023

J Neurol Surg A Cent Eur Neurosurg

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Background and Study Aims: The development of minimally invasive endoscopic neurosurgery has enabled widespread application of endoscopic surgery via the ipsilateral transfrontal approach for putaminal hematoma evacuation. However, this approach is unsuitable for putaminal hematomas that extend into the temporal lobe. We adopted the endoscopic trans-middle temporal gyrus approach, instead of the conventional surgical approach, for the management of these complicated cases and determined its safety and feasibility. Patients and Methods: Twenty patients with putaminal hemorrhage underwent surgical treatment at the Shinshu University Hospital between January 2016 and May 2021. Of these, two patients with left putaminal hemorrhage that extended into the temporal lobe underwent surgical treatment using the endoscopic trans-middle temporal gyrus approach. The procedure entailed the use of a thinner transparent sheath to reduce the technique’s invasiveness, a navigation system to determine the location of the middle temporal gyrus and the sheath’s trajectory, and an endoscope with a 4K camera for higher image quality and utility. The Sylvian fissure was compressed superiorly using our novel “port retraction technique” (i.e., by tilting the transparent sheath superiorly) to avoid damage to the middle cerebral artery and the Wernicke’s area. Results: The endoscopic trans-middle temporal gyrus approach allowed sufficient hematoma evacuation and hemostasis under endoscopic observation without any surgical complexities or complications. The postoperative course was uneventful in both patients. Conclusion: The endoscopic trans-middle temporal gyrus approach for putaminal hematoma evacuation helps avoid damage to normal brain tissue, which could result from the wide range of motion of the conventional technique, particularly when the hemorrhage extends to the temporal lobe.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%