Transtemporal amygdalohippocampectomy: a novel minimally-invasive technique with optimal clinical results and low cost

Arq Neuropsiquiatr. 2017 Nov;75(11):801-808. doi: 10.1590/0004-282X20170141.

Abstract

Mesial temporal sclerosis creates a focal epileptic syndrome that usually requires surgical resection of mesial temporal structures.

Objective: To describe a novel operative technique for treatment of temporal lobe epilepsy and its clinical results.

Methods: Prospective case-series at a single institution, performed by a single surgeon, from 2006 to 2012. A total of 120 patients were submitted to minimally-invasive keyhole transtemporal amygdalohippocampectomy.

Results: Of the patients, 55% were male, and 85% had a right-sided disease. The first 70 surgeries had a mean surgical time of 2.51 hours, and the last 50 surgeries had a mean surgical time of 1.62 hours. There was 3.3% morbidity, and 5% mild temporal muscle atrophy. There was no visual field impairment. On the Engel Outcome Scale at the two-year follow-up, 71% of the patients were Class I, 21% were Class II, and 6% were Class III.

Conclusion: This novel technique is feasible and reproducible, with optimal clinical results.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amygdala / surgery*
  • Child
  • Epilepsy, Temporal Lobe / surgery*
  • Female
  • Hippocampus / surgery*
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / economics
  • Minimally Invasive Surgical Procedures / methods
  • Neurosurgical Procedures / economics
  • Neurosurgical Procedures / methods
  • Sclerosis / surgery*
  • Temporal Lobe / surgery*
  • Treatment Outcome
  • Young Adult