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Endoscopic-enhanced supra-cerebellar trans-tentorial (SCTT) approach to temporo-mesial region: a multicenter study

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Abstract

Surgical access to the temporo-mesial area may be achieved by several routes such as the sub-temporal, the temporal trans-ventricular, the pterional/trans-sylvian, and the occipital interhemispheric approaches; nonetheless, none of them has shown to be superior to the others. The supra-cerebellar trans-tentorial approach allows a great exposure of the middle and posterior temporo-mesial region, while avoiding temporal lobe retraction. A prospective multicenter study was designed to collect data on patients undergoing endoscopic-enhanced SCTT approach to excise left temporo-mesial lesions. The study involved 5 different neurosurgical European centers and ran from 2015 to 2020. All patients had preoperative as well as postoperative brain MRI and ophthalmology evaluation. A total of 30 patients were included in this study, the mean follow-up was 44 months (range 18 to 84 months), male/female ratio was 16/14, and mean age was 39 years. A gross total resection was achieved in 29/30 (96.7%) cases. All surgical procedures were uneventful, without transient or permanent neurological deficits thanks to the preservation of the posterior cerebral artery. The endoscopic-enhanced SCTT approach provides satisfactory exposure to the left temporo-mesial region. Its minimally invasive nature helps minimize the surgical risks related to vascular and white tract manipulation, which represent known limitations of open microsurgical as well as other approaches.

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Authors and Affiliations

  1. Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France

    Andres Coca, Julien Todeschi, Ismail Zaed, Guillame Dannhoff, Charles-Henry Mallereau, Hélène Cebula, Marie des Neiges Santin, Francois Proust, Beniamino Nannavecchia & Salvatore Chibbaro

  2. Department of Neurosurgery, Oxford University Hospital, Oxford, UK

    Mario Ganau

  3. Department of Neurosurgery, Modena University Hospital, Modena, Italy

    Antonio Romano

  4. Department of Neurosurgery, Bonomo Hospital, Andria, Italy

    Carmen Bruno

  5. Department of Neurosurgery, “Casa Sollievo della Sofferenza Hospital”, San Giovanni Rotondo, Italy

    Luciano Savarese

  6. Neuroradiology Unit, Strasbourg University Hospital, Strasbourg, France

    Raoul Pop & Seyyid Baloglu

Authors
  1. Andres Coca
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  2. Mario Ganau
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  3. Julien Todeschi
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  4. Ismail Zaed
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  15. Seyyid Baloglu
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  16. Salvatore Chibbaro
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Contributions

Concept and design: Coca, Ganau, Todeschi, Chibbaro, Zaed. Acquisition of data: Coca, Ganau, Romano, Bruno, Savarese, Chibbaro. Analysis and interpretation of data: Chibbaro, Ganau, Zaed. Drafting the article: all authors. Critically revising the article: all authors.

Corresponding author

Correspondence to Ismail Zaed.

Ethics declarations

Ethical approval and consent to participate

Informed consent was obtained from all individual participants included in the study.

Human and animal ethics

This study was performed in line with the principles of the Declaration of Helsinki. The study was approved by the IRB of the French National Neurosurgery society (authorization no.: IRB00011687, College de neurochirurgie IRB #1: 2022/24).

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The authors affirm that human research participants provided informed consent for publication.

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The authors declare no competing interests.

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Coca, A., Ganau, M., Todeschi, J. et al. Endoscopic-enhanced supra-cerebellar trans-tentorial (SCTT) approach to temporo-mesial region: a multicenter study. Neurosurg Rev 45, 3749–3758 (2022). https://doi.org/10.1007/s10143-022-01881-6

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  • DOI: https://doi.org/10.1007/s10143-022-01881-6

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