Mini Temporal Craniotomy Using Anatomical Surface Landmarks for Temporal Lobe Epilepsy: Technical Note and Clinical...

Area of Science:

• Neurosurgery
• Epilepsy Surgery

Background:

• Standard temporal lobectomy for temporal lobe epilepsy (TLE) involves a large frontotemporal craniotomy.
• A less invasive approach may offer comparable outcomes with reduced morbidity.

Purpose of the Study:

• To describe the technique of minitemporal craniotomy (3x3cm) for TLE without navigation.
• To analyze the clinical outcomes of patients who underwent this procedure.

Main Methods:

• Retrospective analysis of 48 consecutive TLE patients operated between 2014-2019.
• Surgery performed using minitemporal craniotomy and surface anatomical landmarks only.

Main Results:

• 48 patients underwent surgery with minimal complications (3 transient hemiparesis).
• High rates of Class I seizure outcome observed for various pathologies including mesial temporal sclerosis (82%), DNET (100%), gangliogliomas (100%), and NCC (100%).
• Patients with MTS and FCD also showed favorable outcomes (80% Class I).

Conclusions:

• Minitemporal craniotomy is a viable technique for TLE, even in peripheral centers without neuronavigation.
• The procedure offers good seizure control and cosmetic results.