Abstract BACKGROUND: Different surgical approaches have been developed for dealing with third ventricle lesions, all aimed at obtaining a safe removal minimizing brain manipulation. The supraorbital subfrontal trans-lamina terminalis route, commonly employed only for the anterior third ventricle, could represent, in selected cases with endoscopic assistance, an alternative approach to posterior third ventricular lesions. METHODS: Seven patients underwent a supraorbital subfrontal trans-laminar endoscope-assisted approach to posterior third ventricle tumors (two craniopharyngiomas, one papillary tumor of the pineal region, one pineocytoma, two neurocytomas, one glioblastoma). Moreover, a conventional third ventriculostomy was performed via the same trans-laminar approach in four cases. RESULTS: Complete tumor removal was accomplished in four cases, subtotal removal in two cases, and a simple biopsy in one case. Adjuvant radiotherapy and/or chemotherapy was administered, if required, on the basis of the histologic diagnosis. No major complications occurred after surgery except for an intratumoral hemorrhage in a patient undergoing a biopsy for a glioblastoma, which simply delayed the beginning of adjuvant radiochemotherapy. No ventriculoperitoneal shunt placement was needed in these patients at the most recent clinical and radiologic session (average 39.57 months, range 13-85 months). Two illustrative cases are presented. CONCLUSIONS: The supraorbital subfrontal trans-laminar endoscope-assisted approach may provide, in selected cases, an efficient and safe route for dealing with posterior third ventricular tumors. KEYWORDS: Endoscopic assistance; Key-hole approach; Minimally invasive surgery; Posterior third ventricle tumor; Supraorbital subfrontal approach; Trans-lamina terminalis

Supraorbital subfrontal trans-laminar endoscope-assisted approach for tumors of the posterior third ventricle / Iacoangeli, Maurizio; Colasanti, Roberto; Esposito, Domenic; Di Rienzo, Alessandro; di Somma, Lucia; Dobran, Mauro; Gladi, Maurizio; Scerrati, Massimo. - In: ACTA NEUROCHIRURGICA. - ISSN 0001-6268. - STAMPA. - 159:4(2017), pp. 645-654. [10.1007/s00701-017-3117-0]

Supraorbital subfrontal trans-laminar endoscope-assisted approach for tumors of the posterior third ventricle

IACOANGELI, MAURIZIO;COLASANTI, ROBERTO;DOBRAN, MAURO;GLADI, MAURIZIO;SCERRATI, Massimo
2017-01-01

Abstract

Abstract BACKGROUND: Different surgical approaches have been developed for dealing with third ventricle lesions, all aimed at obtaining a safe removal minimizing brain manipulation. The supraorbital subfrontal trans-lamina terminalis route, commonly employed only for the anterior third ventricle, could represent, in selected cases with endoscopic assistance, an alternative approach to posterior third ventricular lesions. METHODS: Seven patients underwent a supraorbital subfrontal trans-laminar endoscope-assisted approach to posterior third ventricle tumors (two craniopharyngiomas, one papillary tumor of the pineal region, one pineocytoma, two neurocytomas, one glioblastoma). Moreover, a conventional third ventriculostomy was performed via the same trans-laminar approach in four cases. RESULTS: Complete tumor removal was accomplished in four cases, subtotal removal in two cases, and a simple biopsy in one case. Adjuvant radiotherapy and/or chemotherapy was administered, if required, on the basis of the histologic diagnosis. No major complications occurred after surgery except for an intratumoral hemorrhage in a patient undergoing a biopsy for a glioblastoma, which simply delayed the beginning of adjuvant radiochemotherapy. No ventriculoperitoneal shunt placement was needed in these patients at the most recent clinical and radiologic session (average 39.57 months, range 13-85 months). Two illustrative cases are presented. CONCLUSIONS: The supraorbital subfrontal trans-laminar endoscope-assisted approach may provide, in selected cases, an efficient and safe route for dealing with posterior third ventricular tumors. KEYWORDS: Endoscopic assistance; Key-hole approach; Minimally invasive surgery; Posterior third ventricle tumor; Supraorbital subfrontal approach; Trans-lamina terminalis
2017
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11566/249763
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