Essay On Anteromesial Lobectomy

1610 Words 6 Pages
For patients with temporal lobe epilepsy there is a high resistant to medication. This leads to a risk of memory impairments and mood disturbances. Long-term this leads to quality of life impairments and an increased risk of death. Due to the resistant to medication surgery is recommended for patients with TLE. Anteromesial temporal lobectomy (AMTL) is the most common surgery for the treatment of patients with TLE. AMTL is performed in both children and adults. AMTL is done in 30-40% of surgery resections in children, and 62-73% of resections in adults (Cossu et al, 2008). AMTL is an invasive surgery involving the temporal bone and lobe.
The skin and other layers protect the temporal muscle and bone. The skin is the most superficial layer,
…show more content…
The parahippocampal gyrus is located superiorly to the tentorium. The parahippocampal gyrus covers the hippocampus, and uncus medially, and is bound inferiorly and laterally by the collateral sulcus. The uncus houses the primary olfactory cortex. The anterior calcarine sulcus is found at the posterior end of the parahippocampal gyrus. The anterior parahippocampal gyrus forms the uncus. It runs medially and curves posteriorly forming the uncal notch sulcus. The uncus is also formed by the medial extension of the hippocampus. It continues along the superior surface of the globus pallidus. The hippocampus has a C shape and occupies the medial surface and the floor of the temporal horn. The hippocampus is divided into the head, the body, and the tail. The head includes the largest area and extends anteriorly to the lateral eminence. The head ends posteriorly at the choroidal fissure. The body of the hippocampus starts that the choroidal fissure and runs posteriorly and superiorly toward the lateral ventricle. The tail of the hippocampus is found at the posterior intraventricular region.. The amygdala occupies the depth of the medial temporal lobe. Superiorly the amygdala is connected to the striatum. The posterior and inferior border is bounded by the anterior temporal horn. The amygdala runs rostral to the uncus and lies anteriorly to and overlaps the hippocampal head. The amygdala forms the ventral superior …show more content…
To avoid injury to the facial nerve the incision beings superior to the zygomatic arch and anterior to the tragus. The incision continues superiorly turning posteriorly at the superior point of the pinna and follows the superior temporal line. The incision ends at the natural hair line. The superficial temporal artery is palpated and mobilized to avoid damage. An incision and flap is then made through the temporal fascia, temporal muscle, and periosteum. To preserve muscle innervation and vascular supply the periosteum is kept attached to the temporal muscle. The temporal bone is now exposed. Three burr holes are made one superiorly to the zygomatic arch, one on the superior temporal line, and one posterior to the burr hole near the zygomatic arch. The dura mater is dissected and the bone flap is removed. The greater wing of the sphenoid bone is also removed for exposure for the amygdala. Bone is also removed along the inferior portion of the temporal fossa and towards the zygomatic bone. The Sylvain fissure, Sylvain vein, superior and middle temporal gyri, and upper part of the inferior temporal gyri are

Related Documents