Temporal Lobe Resections

Zentner, Josef

doi:10.1007/978-3-030-48748-5_6

Cited by 2 publications

(1 citation statement)

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“…at the MUV. ATL was performed as standard temporal lobectomy, 17 with patients who had seizure onset in the dominant hemisphere (13 patients) receiving a 3–4 cm and 4–5 cm and patients with seizure onset in the nondominant hemisphere (19 patients) receiving a 4–5‐cm en bloc resection, respectively. One ATL patient received a hippocampal‐sparing left‐sided resection.…”

Section: Methodsmentioning

confidence: 99%

Visual outcomes after anterior temporal lobectomy and transsylvian selective amygdalohippocampectomy: A quantitative comparison of clinical and diffusion data

et al. 2023

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Objective: Anterior temporal lobectomy (ATL) and transsylvian selective amygdalohippocampectomy (tsSAHE) are effective treatment strategies for intractable temporal lobe epilepsy but may cause visual field deficits (VFDs) by damaging the optic radiation (OpR). Due to the OpR's considerable variability and because it is indistinguishable from surrounding tissue without further technical guidance, it is highly vulnerable to iatrogenic injury. This imaging study uses a multimodal approach to assess visual outcomes after epilepsy surgery. Methods:We studied 62 patients who underwent ATL (n = 32) or tsSAHE (n = 30). Analysis of visual outcomes was conducted in four steps, including the assessment of (1) perimetry outcome (VFD incidence/extent, n = 44/40), (2) volumetric OpR tractography damage (n = 55), and the (3) relation of volumetric OpR tractography damage and perimetry outcome (n = 35). Furthermore, (4) fixel-based analysis (FBA) was performed to assess micro-and macrostructural changes within the OpR following surgery (n = 36).Results: Altogether, 56% of all patients had postoperative VFDs (78.9% after ATL, 36.36% after tsSAHE, p = .011). VFDs and OpR tractography damage tended to be more severe within the ATL group (ATL vs. tsSAHE, integrity of contralateral upper quadrant: 65% vs. 97%, p = .002; OpR tractography damage: 69.2 mm 3 vs.3.8 mm 3 , p = .002). Volumetric OpR tractography damage could reliably predict VFD incidence (86% sensitivity, 78% specificity) and could significantly explain VFD extent (R 2 = .47, p = .0001). FBA revealed a more widespread decline of fibre cross-section within the ATL group.

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Section: Methodsmentioning

confidence: 99%