Minicraniotomy for standard temporal lobectomy: a minimally invasive surgical approach

Introduction. The common surgical approach for standard temporal lobectomy is a question-mark skin incision and a frontotemporal craniotomy. Herein, we describe minicraniotomy approach through a linear skin incision for standard temporal lobectomy. Methods. A retrospective observational cohort study was conducted for a group of consecutive 21 adult patients (group I) who underwent minicraniotomy for standard temporal lobectomy utilizing a linear skin incision. This group was compared to a consecutive 17 adult patients (group II) who previously underwent a reverse question-mark skin incision and standard frontotemporal craniotomy. Results. The mean age was 29 and 23 for groups I and II, respectively. The mean estimated blood loss was 190 mL and 280 mL in groups I and II, respectively (P = 0.019). Three patients in group II developed chronic postcraniotomy headache compared to none in group I. Cosmetic outcome was excellent in group I while 4 patients in group II developed disfiguring depression at lateral sphenoid wing and anterior temple. In group I 17 out of 21 became seizure-free at one-year followup. Conclusion. Minicraniotomy through a linear skin incision is a sufficient surgical approach for effective standard temporal lobectomy and it has an excellent cosmetic outcome.