Abstract：
OBJECTIVE: To assess whether the middle temporal gyrus (MTG) approach to mesial temporal lobe (MTL) tumours is an effective procedure for the treatment of epilepsy in children.
OBJECTIVE: MTL tumours are a common cause of drug-resistant epilepsy in children. There is as yet no consensus regarding their treatment. One possibility is resection via a MTG approach.
METHODS: We assessed the medical records of patients treated at the Department of Neurosurgery, Children\'s Memorial Health Institute,Warsaw, Poland between 2002 and 2020. A prospectively maintained database including clinical, laboratory, and radiographic presentation, as well as pre- and post-operative course, was analysed. Patients with at least a one- -year follow-up were included.
RESULTS: There were 14 patients aged 4-18 years who underwent a MTG approach for a MTL tumour. All presented with epileptic seizure, and none had neurological deficit on admission to hospital. Median follow-up was 2.5 years. Neuronavigation was used to adjust the approach, localise the temporal horn, and achieve radical resection of the tumour and the hippocampus. Gross total resection was performed in all cases. In most patients, histopathological examination revealed ganglioglioma. One patient had transient aphasia. Two patients developed hemiparesis after surgery, which later improved. One of them also experienced visual disturbances. Acute complications were more frequent in younger patients (p = 0.024). In all cases, MRI confirmed complete resection and there was no tumour recurrence during the follow-up period. 13/14 patients remained seizure-free (Engel class I).
CONCLUSIONS: The MTG approach to MTL tumours is an effective procedure for the treatment of epilepsy in children. It avoids removal of the lateral temporal lobe and poses only a minor risk of permanent neurological complications.
OBJECTIVE: MTL tumours are a common cause of drug-resistant epilepsy in children. There is as yet no consensus regarding their treatment. One possibility is resection via a MTG approach.
METHODS: We assessed the medical records of patients treated at the Department of Neurosurgery, Children\'s Memorial Health Institute,Warsaw, Poland between 2002 and 2020. A prospectively maintained database including clinical, laboratory, and radiographic presentation, as well as pre- and post-operative course, was analysed. Patients with at least a one- -year follow-up were included.
RESULTS: There were 14 patients aged 4-18 years who underwent a MTG approach for a MTL tumour. All presented with epileptic seizure, and none had neurological deficit on admission to hospital. Median follow-up was 2.5 years. Neuronavigation was used to adjust the approach, localise the temporal horn, and achieve radical resection of the tumour and the hippocampus. Gross total resection was performed in all cases. In most patients, histopathological examination revealed ganglioglioma. One patient had transient aphasia. Two patients developed hemiparesis after surgery, which later improved. One of them also experienced visual disturbances. Acute complications were more frequent in younger patients (p = 0.024). In all cases, MRI confirmed complete resection and there was no tumour recurrence during the follow-up period. 13/14 patients remained seizure-free (Engel class I).
CONCLUSIONS: The MTG approach to MTL tumours is an effective procedure for the treatment of epilepsy in children. It avoids removal of the lateral temporal lobe and poses only a minor risk of permanent neurological complications.
摘要：
目的：评估中颞叶回（MTG）方法治疗中颞叶（MTL）肿瘤是否是治疗儿童癫痫的有效方法。
目的：MTL肿瘤是儿童耐药性癫痫的常见原因。目前尚未就其治疗达成共识。一种可能性是通过MTG方法切除。
方法：我们评估了神经外科患者的医疗记录，儿童纪念健康研究所，华沙,波兰在2002年至2020年之间。前瞻性维护的数据库，包括临床，实验室,和射线照相显示，以及手术前和手术后的过程，进行了分析。包括至少一年随访的患者。
结果：有14名年龄在4-18岁之间的患者接受了MTG方法治疗MTL肿瘤。都出现了癫痫发作，入院时没有神经缺损。中位随访时间为2.5年。神经导航被用来调整方法，定位颞角，并实现肿瘤和海马的根治性切除。所有病例均进行了大体全切除。在大多数患者中，组织病理学检查显示神经节胶质瘤。1例患者出现短暂性失语。两名患者在手术后出现偏瘫，后来改进了。其中一人还经历了视觉障碍。急性并发症在年轻患者中更为常见（p=0.024）。在所有情况下,MRI证实完全切除，随访期间无肿瘤复发。13/14患者仍无癫痫发作（EngelI类）。
结论：MTG治疗MTL肿瘤是治疗儿童癫痫的有效方法。它避免了颞叶外侧的去除，并且仅造成永久性神经系统并发症的微小风险。
目的：MTL肿瘤是儿童耐药性癫痫的常见原因。目前尚未就其治疗达成共识。一种可能性是通过MTG方法切除。
方法：我们评估了神经外科患者的医疗记录，儿童纪念健康研究所，华沙,波兰在2002年至2020年之间。前瞻性维护的数据库，包括临床，实验室,和射线照相显示，以及手术前和手术后的过程，进行了分析。包括至少一年随访的患者。
结果：有14名年龄在4-18岁之间的患者接受了MTG方法治疗MTL肿瘤。都出现了癫痫发作，入院时没有神经缺损。中位随访时间为2.5年。神经导航被用来调整方法，定位颞角，并实现肿瘤和海马的根治性切除。所有病例均进行了大体全切除。在大多数患者中，组织病理学检查显示神经节胶质瘤。1例患者出现短暂性失语。两名患者在手术后出现偏瘫，后来改进了。其中一人还经历了视觉障碍。急性并发症在年轻患者中更为常见（p=0.024）。在所有情况下,MRI证实完全切除，随访期间无肿瘤复发。13/14患者仍无癫痫发作（EngelI类）。
结论：MTG治疗MTL肿瘤是治疗儿童癫痫的有效方法。它避免了颞叶外侧的去除，并且仅造成永久性神经系统并发症的微小风险。
