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Updated: Jun 19, 2026
Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection
Published on: April 12, 2024
Optimized Stereo-Electroencephalography-Guided Three-Dimensional Radiofrequency Thermocoagulation for Hypothalamic
Yang Dai1,2, Yihe Wang1,2,3, Zesheng Li1,2
1Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Background:
The high risk of resection surgery for hypothalamic hamartoma (HH) epilepsy drives interest in minimally invasive treatment. Stereo-electroencephalography-guided three-dimensional radiofrequency thermocoagulation (SEEG-3D RFTC) offers an alternative option. We investigated this technology's efficacy, safety, and prognostic risk factors.
Methods:
Patients with HH who underwent SEEG-3D RFTC were retrospectively analyzed. A high-density focal stereo-array electrode implantation was adopted. SEEG-3D RFTC was performed between two contiguous contacts of the same electrode or adjacent contacts of different electrodes. Outcomes were separately evaluated for clinical seizures, gelastic seizures (GS), and non-gelastic seizures (nGS). Kaplan-Meier survival analysis was used to assess treatment effectiveness. Risk factors were analyzed using log-rank tests and Cox regression analyses.
Results:
Sixty-nine patients were enrolled. The mean follow-up was 41.00 ± 18.19 months. Seizure freedom was obtained by 48/69 (69.57%) patients for clinical seizures, 50/62 (80.65%) patients for GS, and 41/54 (75.93%) patients for nGS. Surgical procedures were well tolerated. In this study, the proportion of patients experiencing long-term complications was 10.14%. The percentages of HH ablation (p = 0.003; hazard ratio 0.956, 95% confidence interval 0.928-0.985) and HH attachment ablation (p = 0.001; hazard ratio 0.931, 95% confidence interval 0.892-0.970) were significantly associated with seizure outcomes.
Conclusions:
Optimized SEEG-3D RFTC is an effective and safe option for HH-related epilepsy and is especially suitable for use where laser interstitial thermal therapy is unavailable. Complete ablation of the HH and attachment site is essential for good outcomes.
