title: Carbon dioxide laser for corpus callosotomy in the pediatric population.
abstract: OBJECTIVE
  The authors describe the application of a flexible CO2 laser for corpus callosotomy in children with epilepsy.
  
  
  METHODS
  This retrospective case series reviews all cases in which pediatric patients underwent a corpus callosotomy performed using the CO2 OmniGuide laser between May 2005 and October 2012. Data were collected from 8 corpus callosotomy procedures in 6 pediatric patients presenting with medically refractory epilepsy marked by drop attacks.
  
  
  RESULTS
  Complete corpus callosotomies were performed in 6 patients (3 boys, 3 girls; ages 5-14 years). In 4 patients the complete callosotomy occurred as a single procedure, and in 2 patients an anterior two-thirds callosotomy was performed first. These 2 patients subsequently required a complete callosotomy due to inadequate control of their drop attacks. In all cases there was clean lesioning of the tract with preservation of the ependymal plane and less inadvertent thermal tissue damage due to low penetration of the laser through cerebrospinal fluid. All patients had resolution or improvement of drop attacks after surgery. No complications were encountered, and imaging demonstrated a clean sectioning of callosal fibers with preservation of normal ventricular anatomy.
  
  
  CONCLUSIONS
  These cases illustrate the use of this device in completing corpus callosotomy in pediatric patients. The low-profile laser fiber tip was well suited for working in the depths of the interhemispheric fissure with minimal brain retraction. The flexible CO2 laser allows a precise callosal lesioning through an interhemispheric approach and is a useful adjunct to be employed in these cases.
authors.affiliation: Division of Pediatric Neurosurgery, Department of Neurosurgery.
authors.forename: Omar
authors.initials: O
authors.lastname: Choudhri
authors.forename: Robert M
authors.initials: RM
authors.lastname: Lober
authors.forename: Joaquin
authors.initials: J
authors.lastname: Camara-Quintana
authors.forename: Kristen W
authors.initials: KW
authors.lastname: Yeom
authors.forename: Raphael
authors.initials: R
authors.lastname: Guzman
authors.forename: Michael S B
authors.initials: MS
authors.lastname: Edwards
mesh_terms: D000293:Adolescent; D001921:Brain / Q000503:physiopathology; D002245:Carbon Dioxide; D002648:Child; D002675:Child, Preschool; D003337:Corpus Callosum / Q000601:surgery*; D004827:Epilepsy / Q000601:surgery*; D005260:Female; D006801:Humans; D054020:Lasers, Gas; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D013575:Syncope / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D002245:Carbon Dioxide
keywords: EEG = electroencephalography; carbon dioxide laser; corpus callosotomy; epilepsy surgery; microsurgery