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目的探讨经锁孔颞下入路选择性杏仁核海马切除术治疗颞叶内侧癫的手术方法及疗效。方法回顾性分析29例颞叶内侧癫的病例资料,均在全麻下行后颞锁孔开颅,经梭状回造瘘进入侧脑室颞角,分块切除杏仁核海马及海马旁回等颞叶内侧结构。结果 29例病人术后平均随访43个月,Engel癫疗效分级:Ⅰ级24例,Ⅱ级2例,Ⅲ级2例,Ⅳ级1例。无失语、严重记忆力减退及视野缺损发生。结论选择性杏仁核海马切除术是治疗颞叶内侧癫的有效方法,创伤小,可妥善保护语言区、颞干和视放射。
Objective To investigate the surgical treatment of the medial temporal lobe epilepsy treated with keyhole approach and selective subepithelial hippocampus. Methods A retrospective analysis of 29 cases of temporal lobe medial epilepsy data, all underwent temporal keyhole craniotomy craniotomy, fusiform gynecological fistula into the lateral horn of the lateral ventricle, block removal of the amygdala hippocampus and parahippocampal back Temporal lobe medial structure. Results The average follow-up of 29 patients was 43 months. Engel’s epilepsy efficacy grade was 24 grade Ⅰ, 2 grade Ⅱ, 2 grade Ⅲ, and 1 grade Ⅳ. No aphasia, severe memory loss and visual field defect occurred. Conclusion Selective amygdala resection is an effective method for the treatment of medial temporal lobe epilepsy. The trauma is small and the lingual area, temporal stem and visual radiation can be properly protected.