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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(03): 660-665
DOI: 10.4103/ajns.AJNS_29_20
Technical Note

Translamina terminalis approach to the hypothalamus using supraorbital craniotomy: Technical note and comparison with other surgical corridors

Mohammed Alhoobi
1   Department of Neurosurgery, Hamad Medical Corporation, Doha
,
Adnan Khan
1   Department of Neurosurgery, Hamad Medical Corporation, Doha
,
Fatma Abu-Qadous
1   Department of Neurosurgery, Hamad Medical Corporation, Doha
,
Ralf Kockro
2   Department of Neurosurgery, Hirslanden Klinik, Zurich
,
Firas Hammadi
1   Department of Neurosurgery, Hamad Medical Corporation, Doha
,
Raed Jarir
1   Department of Neurosurgery, Hamad Medical Corporation, Doha
,
Sirajeddin Belkhair
1   Department of Neurosurgery, Hamad Medical Corporation, Doha
3   Department of Surgery, Michigan State University, Lansing, US
,
Ali Ayyad
1   Department of Neurosurgery, Hamad Medical Corporation, Doha
4   Department of Neurosurgery, Saarland University Hospital, Homburg, Germany
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Objectives: Approaches to the hypothalamus and anterior third ventricle are variable. We present a technical note on access of the hypothalamus using the trans-lamina terminalis approach by supraorbital craniotomy in a patient who had a hypothalamic cavernoma and presented to us with recurrent hemorrhage. Patients and methods: The trans-lamina terminalis approach, including anatomical landmarks and surgical steps through a supra-orbital craniotomy, is described and a comparison with other surgical corridors is discussed. Results: The supraorbital trans lamina terminalis approach allowed an effective access to the hypothalamic lesions. This approach provided a safe and minimally invasive corridor for gross total resection of the lesion since trespass of viable brain tissue is avoided. One clinical case illustrates the feasibility of the approach allowing complete removal of a cavernoma without surgery related neurological of endocrinological deficits. Conclusions: The supra-orbital craniotomy for trans-lamina terminalis approach is a valid surgical choice for hypothalamic lesions. The major strengths of this approach include minimal brain retraction and direct end-on view; however, the long and narrow surgical corridor requires some technical familiarization. The clinical outcomes are comparable to other surgical corridors.

Key-words:

Hypothalamic cavernoma - supraorbital craniotomy - translamina approach

Financial support and sponsorship

Nil.




Publication History

Received: 21 January 2020

Accepted: 16 April 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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