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Logo of neuroncolAboutAuthor GuidelinesEditorial BoardNeuro-Oncology
 
Neuro Oncol. 2017 January; 19(Suppl 1): i14.
Published online 2017 March 2. doi:  10.1093/neuonc/now293.051
PMCID: PMC5358625

PP51. SURGICAL CHALLENGES OF PRESERVING QUALITY OF LIFE IN POSTERIOR MEDIOBASAL TEMPORAL LOW AND HIGH GRADE GLIOMAS. ANATOMICAL WHITE MATTER FIBER DISSECTION STUDY AND VIDEO ANALYSIS OF THE POSTERIOR SUBTEMPORAL APPROACH

Abstract

OBJECTIVES: Anatomical and surgical analysis of the posterior subtemporal approach to address intrinsic lesions of the posterior mediobasal temporal region while preserving cortical and subcortical structures related to language functions and integrity of optic pathways. SUBJECTS: 10 cadaveric hemispheres were dissected according to Klinger’s technique to reveal the anatomy of the optic pathways, tapetum fibers and of the mediobasal temporal region. Video analysis of two patients harbouring a low grade and high grade glioma in the posterior mediobasal temporal region in the dominant and non-dominant hemisphere respectively. METHODS: Electronic datas, intraoperative video and imaging reviewed with 3D VP Reveal platform and feasibility of the approach analysed. Datas collected were reviewed according to the anatomical findings in the cadaveric specimens. RESULTS AND CONCLUSION: The subtemporal approach allows microsurgical access to the mediobasal temporal region providing good surgical exposure to perform an adequate resection of both low and high grade gliomas, while preserving structures related to vision and language functions, therefore preserving quality of life. Differently from the anterior temporal region, the posterior temporal region is located above the petrous ridge and tentorium proving a flat antero-posterior and latero-medial basal cisternal corridor to the mediobasal structures, anterior or posterior to the vein of Labbe’ complex. Mastering cortical and subcortical anatomy of the posterior temporal region, relationships of the collateral sulcus with the trigone as well as the anatomy of the venous system is the conditio sine qua non for a safe removal of posterior mediobasal temporal gliomas.


Articles from Neuro-Oncology are provided here courtesy of Society for Neuro-Oncology and Oxford University Press