• Yasushi Miyagi, Fumio Shima, Katsuya Ishido, Takehisa Araki, Yoshihide Taniwaki, Iku Okamoto, and Kazufumi Kamikaseda.
• Department of Stereotactic and Functional Neurosurgery, Kaizuka Hospital, Fukuoka, Japan. SuiteCello@aol.com
• Neurosurgery. 2003 May 1; 52 (5): 1117-23; discussion 1123-4.

ObjectiveTo describe a surgical technique for a minimally invasive transcortical transventricular amygdalohippocampectomy via the inferior temporal sulcus (ITS) using a stereotactic navigator.MethodsSeven patients with medically intractable mesial temporal lobe epilepsy underwent an amygdalohippocampectomy via the ITS. By use of a laser-guided navigation system, the epileptogenic foci of the mesial temporal lobe were resected through a small linear operative route that was made by a brain speculum inserted from the ITS to the anterolateral floor of the temporal horn in the lateral ventricle.ResultsAll patients completed at least a 1-year follow-up (range, 14-45 mo) after surgery and had improved neuropsychological parameters as a result of the operation. All patients became seizure-free after surgery. A Humphrey visual field perimeter detected no hemianopsia.ConclusionCombined with the stereotactic navigation system, the ITS approach provides the least invasive amygdalohippocampectomy that preserves optic radiation. This approach seems beneficial especially in patients in whom the epileptic lesions are limited to the anterior mesial temporal lobe.

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