J Neurosurg 143:738–747, 2025
Over 26 years, keyhole craniotomy via the inferior temporal gyrus for mesial temporal lobe surgery showed a low complication rate (5.3%), with only 0.3% permanent neurological deficits. Technique refinement and perioperative strategies minimized risks, supporting this approach as safe and effective for temporal lobe pathology.
A 26-year, single-surgeon study reviewed 717 mesial temporal lobe (MTL) surgeries using a keyhole inferior temporal gyrus (ITG) approach for epilepsy and other pathologies.
• Overall complication rate was low (5.3%), with only 0.3% of patients experiencing permanent neurological deficits and no perioperative deaths.
• Most common complications were hemorrhage (1.5%), postoperative seizure (1.3%), and cosmetic defects (0.6%).
• Neurological complications included transient cranial nerve deficits, visual field deficits, and speech difficulty, all rare.
• No significant correlation found between complications and age, sex, pathology type, operative time, or blood loss.
• Technical strategies such as meticulous closure, careful muscle reapproximation, and limiting brain retraction reduced complications over time.
• The ITG keyhole approach provided safe, effective, and cosmetically favorable access to the MTL, with complication rates improving as technique and teaching matured.
• Long-term follow-up (97% at 36 months) confirmed sustained safety and efficacy of this approach.
You must be logged in to post a comment.