Abstract:
Objective To explore the surgical resection strategy as well as short-term outcome of gliomas in medial temporal lobe according to the anatomy and various intraoperative auxiliary techniques.
Methods The clinical data including clinical and imaging manifestations, preoperative evaluation, surgical approaches, technical points and recent prognosis in 17 patients with medial temporal lobe glioma undergoing surgical resection were retrospectively analyzed. The surgical approaches and resection strategies were guided according to the patients′ multimodal cranial MRI results before operation. The cranial CT and MRI were performed again in early postoperative stage. The recovery of patients was evaluated before discharge and 1 month after operation.
Results According to the preoperative evaluation, 12 patients underwent the modified anterior inferior temporal approach, 4 patients underwent the middle temporal gyrus approach, and 1 patient underwent the superior temporal sulcus approach. Total resection of the tumor was achieved in 15 cases (88.2%), and subtotal resection was in 2 cases (11.8%). There were 2 cases of new limb dyskinesia (1 case complicated with sensory aphasia), 1 case of oculomotor nerve injury after operation, and all the above symptoms were improved after 1 month follow-up. The remaining 14 patients showed improvement in postoperative performance compared to preoperation, with no comatose or deceased patients.
Conclusions Medial temporal lobe is deep and complex in anatomy. The further understanding of its anatomy and adopting reasonable surgical strategy are helpful for the total resection of gliomas in this area and the protection of patients′ neurological functions. Multimodal neuroimaging and intraoperative neuronavigation technique have significant assistant value.
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