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首页> 外文期刊>Acta Neurochirurgica >Temporal mediobasal tumors: a proposal for classification according to surgical anatomy.
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Temporal mediobasal tumors: a proposal for classification according to surgical anatomy.

机译：颞中叶肿瘤：根据手术解剖学分类的建议。

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OBJECTIVE: Development of a classification for temporal mediobasal tumors based on anatomical and neuroradiological aspects to help evaluate surgical accessibility and risk. METHODS: Preoperative magnetic resonance imaging, surgical approaches and outcomes of 235 patients with a temporal mediobasal tumor were analyzed retrospectively. Surgical landmarks were defined in accordance with operative anatomy. Previous classifications of these tumors were reviewed and a new classification system was developed. RESULTS: The new classification system recognises four types of temporal mediobasal tumor based on anatomical landmarks, location, and size. Type A comprises lesions confined to the uncus, hippocampus, parahippocampus, and/or amygdala. Type B comprises lesions in the area immediately lateral to the structures where type A tumors are located but sparing lateral gyri. Type C tumors are larger lesions, which occupy the area of type A and type B simultaneously. Type D tumors originate from the temporal mediobasal region and invade into the adjacent structures of the temporal stem, insular cortex, claustrum, putamen, or pallidum. The area occupied by a tumor in the axial plane was divided into anterior (a) and posterior (p) subregions. Progressive grading from A to D and from "a" to "p" was based on the view that larger and more posteriorly growing tumors were more difficult to remove. Lesions located in the anterior subregion (n = 173) were easier to remove by the transsylvian route (39%) or after partial anterior lobectomy (32%). For the posterior lesions (n = 62), a subtemporal approach was more appropriate (75%). CONCLUSIONS: Based on a series of 235 temporal mediobasal tumors, a classification system was designed to aid in decision making about operability, surgical risk, and approach.
机译：目的：根据解剖学和神经放射学方面的进展，对颞下颌肿瘤进行分类，以帮助评估手术的可及性和风险。方法：回顾性分析235例颞下颌基底肿瘤患者的术前磁共振成像，手术方法和预后。根据手术解剖定义手术标志。这些肿瘤的以前的分类进行了审查，并开发了一个新的分类系统。结果：新的分类系统根据解剖标志，位置和大小识别四种类型的颞下颌肿瘤。 A型包括局灶性，海马，海马旁和/或杏仁核的病变。 B型包括紧邻A型肿瘤所在结构的外侧区域的损伤，但不包括外侧回旋。 C型肿瘤是较大的病变，同时占据A型和B型区域。 D型肿瘤起源于颞中上部区域，并侵入颞干，岛状皮层，锁骨，壳核或苍白球的相邻结构。肿瘤在轴向平面中占据的区域分为前（a）和后（p）子区域。从A到D以及从“ a”到“ p”的逐步分级是基于这样的观点，即更大，更向后生长的肿瘤更难清除。位于前亚区域的病变（n = 173）更容易通过经希尔德维亚途径（39％）或部分前叶切除术（32％）去除。对于后部病变（n = 62），次颞下入路更为合适（75％）。结论：基于一系列235例颞中叶肿瘤，设计了一个分类系统，以帮助做出有关可操作性，手术风险和方法的决策。

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