gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

The subtemporal approach to anterolateral ponto-mesencephalic cavernomas

Der subtemporale Zugang zu anterolateralen ponto-mesencephalen Kavernomen

Meeting Abstract

  • corresponding author L. Benes - Department of Neurosurgery, Philipps-University, Medical Center, Marburg
  • C. Kappus - Department of Neurosurgery, Philipps-University, Medical Center, Marburg
  • U. Sure - Department of Neurosurgery, Philipps-University, Medical Center, Marburg
  • O. Bozinov - Department of Neurosurgery, Philipps-University, Medical Center, Marburg
  • T. Dukatz - Department of Neurosurgery, Philipps-University, Medical Center, Marburg
  • H. Bertalanffy - Department of Neurosurgery, Philipps-University, Medical Center, Marburg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc11.05.-16.09

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0264.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Benes et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

The rhomboid fossa approach is a commonly used route to the ponto-mesencephalic region of the brainstem. There are only a few reports pointing out the indications and advantages of the subtemporal approach for the treatment of ponto-mesencephalic cavernomas. We report on the indication, technique and clinical experience with the subtemporal approach as an important surgical route in selected patients harboring anterolateral brainstem lesions.

Methods

Fourteen patients with cavernous malformations in the anterolateral ponto-mesencephalic region out of a group of 68 surgically treated brainstem cavernomas were approached subtemporally by placing a lumbar drain prior to surgery. All patients were electrophysiologically monitored during surgery. A tentorial incision to enlarge the exposure was performed in all patients. The access route was evaluated on MRI-scans and by transferring data to a neuronavigation workstation. All patients underwent either postoperative MRI or CT scan. The clinical data, patients outcome and the video-documented surgical technique of the subtemporal approach were analyzed.

Results

All patients underwent successful total resection of their cavernoma. There was no severe additional morbidity and mortality due to the subtemporal approach. The vein of Labbé was preserved in all patients. No damage of the neuronal structures in terms of temporal hemorrhage, edema, cranial nerve trauma or temporal lobe contusion was observed postoperatively.

Conclusions

The decision for a subtemporal approach by a limited basal temporal craniotomy needs to be based on anatomical considerations to allow successful treatment of anterolateral ponto-mesencephalic cavernomas with lowest rate of morbidity. The temporal veins do not conflict the approach and are rarely cumbersome when assessing the ponto-mesencephalic region.