title: Endoscope-assisted supracerebellar transtentorial approach to the posterior medial temporal lobe for resection of cavernous malformation.
abstract: The mesial temporal lobe can be approached via a pterional or orbitozygomatic craniotomy, the subtemporal approach, or transcortically. Alternatively, the entire mesial temporal lobe can be accessed using a lateral supracerebellar transtentorial (SCTT) approach. Here we describe the technical nuances of patient positioning, craniotomy, supracerebellar dissection, and tentorial disconnection to traverse the tentorial incisura to arrive at the posterior mesial temporal lobe for a cavernous malformation. The SCTT approach is especially useful for lesions in the dominant temporal lobe where an anterolateral approach may endanger language centers or the vein of Labbé. The video can be found here: https://youtu.be/D8mIR5yeiVw .
authors.affiliation: Department of Neurosurgery, Barrow Neurological Institute and St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
authors.forename: M Yashar S
authors.initials: MY
authors.lastname: Kalani
authors.affiliation: Department of Neurosurgery, Barrow Neurological Institute and St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
authors.forename: Ting
authors.initials: T
authors.lastname: Lei
authors.affiliation: Department of Neurosurgery, Barrow Neurological Institute and St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
authors.forename: Nikolay L
authors.initials: NL
authors.lastname: Martirosyan
authors.affiliation: Department of Neurosurgery, Barrow Neurological Institute and St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Oppenlander
authors.affiliation: Department of Neurosurgery, Barrow Neurological Institute and St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Spetzler
authors.affiliation: Department of Neurosurgery, Barrow Neurological Institute and St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
authors.forename: Peter
authors.initials: P
authors.lastname: Nakaji
mesh_terms: D000328:Adult; D002531:Cerebellum / Q000601:surgery; D003399:Craniotomy / Q000379:methods; D004388:Dura Mater / Q000601:surgery*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D044583:Neuroendoscopy; D019635:Neurosurgical Procedures / Q000379:methods; D013702:Temporal Lobe / Q000601:surgery*
keywords: cavernous malformation; lateral supracerebellar transtentorial approach; mesial temporal lobe; video