Risk factors and the management of entrapped temporal horn following lateral ventricular tumor surgery

Abstract

AIM:To investigate the risk factors and optimize the management of entrapped temporal horn (ETH) following lateral ventricular tumor surgery. MATERIAL and METHODS:We reviewed 41 cases of lateral ventricular tumors treated at the department of neurosurgery of our institution between January 2012 and September 2020. We summarized and analyzed the preoperative symptoms, intraoperative conditions, postoperative complications of the entrapped temporal horn, treatment measures, and recovery. RESULTS:Of 41 patients, 14 (34.1%) had ETH complications. A univariate analysis revealed that the tumor location, tumor diameter, the intraoperative use of hemostatic materials, no extraventricular drainage (EVD) was placed at the end of the operation, tumor stroke, the exposure mode of the tumor boundary, and postoperative meningitis were potential risk factors for the development of ETH. A multivariate binary logistic stepwise regression analysis revealed that tumor diameter ≥3.2 cm (OR=14.808, p=0.037), tumor stroke (OR=50.793, p=0.015), non-EVD (OR=0.023, p=0.033), and the mechanical separation of the tumor boundary (OR=30.617, p=0.045) were risk factors for ETH.CONCLUSION: ETH often occurs following the surgery of lateral ventricle tumors. Large tumor diameter, tumor stroke, non-EVD at the end of operation, and the mechanical separation of the tumor boundary are the risk factors of ETH. The natural exposure of the tumor boundary during surgery, avoiding the use of hemostatic materials, placing an EVD tube at the end of operation, and postoperative infection control can effectively reduce the occurrence of ETH. It is essential to select the appropriate treatment method for patients with postoperative ETH.