Clinical application of transcallosal-hemispheres approaches to the third ventricle

Abstract

Objective To investigate the clinical application of transcallosal-hemispheres approaches to the third ventricle.Methods Twenty cases of the third ventricle tumors were removed through corpus callosum approach,and the results were analysed.Results Twenty patients with the third ventricle tumors,8 cases being located in the anterior portion of the third ventricle,10 cases in the middle portion and 2 cases in the posterior portion,underwent tumor resection via transcallosal interforniceal approach.Total resection of the third ventricle tumors was achieved in 17 cases,subtotal resection in 2 cases and partial resection in 1 case.The pathological examination revealed 6 craniopharyngiomas,4 colloid cysts,2 germ cell tumors,2 astrocytomas,2 pituitary adenomas,2 ependymocytomas,1 meningioma and 1 teratoma.The postoperative complications included polyuria,polydipsia,electrolyte disorder in 6 patients,central high fever in 5 patients,all of them got improved and discharged after treated for 1 week to 2 weeks;short-term memory disturbance occurred and recovered within 3 months in 4 patients.Mutism appeared and recovered in one month in 2 patients.Three patients had hydrocephalus,all of them underwent ventriculoperitoneal shunt with good recovery.Conclusions The transcallosal-interforniceal approach permitted surgery directly,and the paired vital structures could be viewed clearly and they couldn' t be easily damaged,and the whole third ventricle could be adequately revealed.The approach is safe and direct,has the high resection rate,low postoperative complications and minimal mortality,so it is an ideal choice for the resection of third ventricle tumor. Key words: Longitudinal fissure approach; The third ventricle; Callosum; Microsurgical approaches