title: Staged laser interstitial thermal therapy and topectomy for complete obliteration of complex focal cortical dysplasias.
abstract: Anatomically complex focal cortical dysplasias may present significant challenges to safe and complete surgical resection via standard operative corridors. Laser interstitial thermal therapy (LITT) is an emerging minimally invasive technique that may address some of these challenges, enabling stereotactic ablation of deep and/or surgically inaccessible regions. However, complete ablation may not be feasible in all cases. To address this dilemma, we have designed a protocol utilizing staged LITT followed by topectomy to effect complete obliteration of a complex focal cortical dysplasia. The approach presented demonstrates the feasibility, safety, and clinical utility of combining laser ablation and open surgery for the definitive management of this lesion.
authors.affiliation: Department of Neurological Surgery, Columbia University Medical Center, Neurological Institute of New York, 710 West 168th Street, New York, NY 10032, USA. Electronic address: jae2109@columbia.edu.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Ellis
authors.affiliation: Department of Neurological Surgery, Columbia University Medical Center, Neurological Institute of New York, 710 West 168th Street, New York, NY 10032, USA.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Mejia Munne
authors.affiliation: Department of Pathology, Columbia University Medical Center, New York, USA.
authors.forename: Shih-Hsiu
authors.initials: SH
authors.lastname: Wang
authors.affiliation: Department of Neurology, Columbia University Medical Center, New York, USA.
authors.forename: Danielle K
authors.initials: DK
authors.lastname: McBrian
authors.affiliation: Department of Neurology, Columbia University Medical Center, New York, USA.
authors.forename: Cigdem I
authors.initials: CI
authors.lastname: Akman
authors.affiliation: Department of Neurological Surgery, Columbia University Medical Center, Neurological Institute of New York, 710 West 168th Street, New York, NY 10032, USA.
authors.forename: Neil A
authors.initials: NA
authors.lastname: Feldstein
authors.affiliation: Department of Neurological Surgery, Columbia University Medical Center, Neurological Institute of New York, 710 West 168th Street, New York, NY 10032, USA.
authors.forename: Guy M
authors.initials: GM
authors.lastname: McKhann
mesh_terms: D002648:Child; D005625:Frontal Lobe / Q000601:surgery; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D054220:Malformations of Cortical Development / Q000601:surgery*; D011612:Psychosurgery / Q000379:methods*
keywords: Epilepsy; Laser ablation; MRI-guided; Seizure; Stereotactic; Surgery