• Baran Bozkurt, Kaan Yağmurlu, Evgenii Belykh, Tayebi Meybodi Ali A Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA., Michael S Staren, Joseph L Aklinski, Mark C Preul, Andrew W Grande, Peter Nakaji, and Michael T Lawton.
• Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
• World Neurosurg. 2018 Oct 1; 118: 219-229.

ObjectiveTo compare transcallosal-transchoroidal and transcallosal-subchoroidal approaches to the ipsilateral and contralateral edges of the floor of the third ventricle using quantitative analyses.MethodsFive formalin-fixed cadaveric human heads (10 sides) were examined under the operating microscope. Quantitative measurements (area of surgical freedom and angle of attack) were obtained using 3-T magnetic resonance imaging and a StealthStation image guidance system. The limits of the surgical approaches were shown by touching a probe to 6 designated points on the floor of the third ventricle.ResultsThe transchoroidal approach provided greater surgical freedom than the subchoroidal approach to access ipsilateral and contralateral middle landmarks at the edges of the floor of the third ventricle in both longitudinal and horizontal planes (P ≤ 0.03). No significant difference between the 2 approaches was found in accessing the anterior and posterior landmarks of the third ventricle in each plane. The surgical freedom to the contralateral anterior, middle, and posterior landmarks was greater than to the ipsilateral landmarks in both the transchoroidal and subchoroidal approaches.ConclusionsThe transcallosal-transchoroidal approach, compared with the transcallosal-subchoroidal approach, may provide better exposure and require less retraction for removal of ipsilateral or contralateral lesions located in the midbrain or hypothalamus and situated near the floor of the third ventricle. The contralateral transcallosal approach with either the transchoroidal or subchoroidal approach may provide good surgical freedom for removal of lesions located near the floor of the third ventricle, such as lesions in the midbrain.Copyright © 2018 Elsevier Inc. All rights reserved.

19 keywords...

hide…