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

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.

Comparação Entre os Desfechos de Lobectomia Temporal Anterior e Amigdalohipocampectomia Seletiva no Tratamento Cirúrgico da Epilepsia de Lobo Temporal

“…A epilepsia é uma doença que ocorre por transtorno na comunicação neuronal, levando a quadros repetidos de convulsões 1 . Trata-se de uma moléstia crônica e normalmente tratável, cuja prevalência global foi estimada pela Organização Mundial da Saúde (OMS) em cerca de 50 milhões de indivíduos 2,3 . Países de baixa e média renda possuem prevalência da doença de duas a três vezes maior, em comparação a países de alta renda, fato atribuído à maior incidência de condições como neurocisticercose ou malária, além de maiores taxas de sofrimento fetal e acidentes de trânsito nesses países de renda mais baixa 1,3 .…”