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Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes

Hypothalamic hamartoma (HH) is a rare lesion consisting of normal neurons and neuroglia arranged in an abnormal pattern which usually causes gelastic seizures (GS). Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has been developed as a minimally invasive approach to treat HH...

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Autores principales: Yao, Yuan, Wang, Xiu, Hu, Wenhan, Zhang, Chao, Sang, Lin, Zheng, Zhong, Mo, Jiajie, Liu, Chang, Qiu, Jiaji, Shao, Xiaoqiu, Zhang, Jianguo, Zhang, Kai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9658093/
https://www.ncbi.nlm.nih.gov/pubmed/36362807
http://dx.doi.org/10.3390/jcm11216579
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author Yao, Yuan
Wang, Xiu
Hu, Wenhan
Zhang, Chao
Sang, Lin
Zheng, Zhong
Mo, Jiajie
Liu, Chang
Qiu, Jiaji
Shao, Xiaoqiu
Zhang, Jianguo
Zhang, Kai
author_facet Yao, Yuan
Wang, Xiu
Hu, Wenhan
Zhang, Chao
Sang, Lin
Zheng, Zhong
Mo, Jiajie
Liu, Chang
Qiu, Jiaji
Shao, Xiaoqiu
Zhang, Jianguo
Zhang, Kai
author_sort Yao, Yuan
collection PubMed
description Hypothalamic hamartoma (HH) is a rare lesion consisting of normal neurons and neuroglia arranged in an abnormal pattern which usually causes gelastic seizures (GS). Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has been developed as a minimally invasive approach to treat HH and gradually become a first-line treatment. In total, this study enrolled 47 consecutive HH patients that underwent one round of ablation. Patients were followed for at least one year. Patients’ medical records and surgical information were carefully reviewed, and univariate analyses were performed. Of the treated patients, 72.3% remained GS-free in this study, with an overall Engel class I rate of 68.1%. Long-term postoperative complications occurred in six patients. Factors associated with GS prognosis included Delalande classification (p = 0.033), HH volume (p = 0.01), and the ablation rate of the HH body (p = 0.035). The disconnection rate was 0.73 ± 0.14 in the Engel class Ia group as compared to 0.62 ± 0.13 in the Engel Ib–Engel IV group (p = 0.046). MRgLITT represents a safe and effective surgical procedure. Patients with larger or Delalande type IV HH may require multiple rounds of ablation. In addition to assessing the degree of disconnection, ablation volume should also be carefully considered for patients undergoing this procedure.
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spelling pubmed-96580932022-11-15 Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes Yao, Yuan Wang, Xiu Hu, Wenhan Zhang, Chao Sang, Lin Zheng, Zhong Mo, Jiajie Liu, Chang Qiu, Jiaji Shao, Xiaoqiu Zhang, Jianguo Zhang, Kai J Clin Med Article Hypothalamic hamartoma (HH) is a rare lesion consisting of normal neurons and neuroglia arranged in an abnormal pattern which usually causes gelastic seizures (GS). Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has been developed as a minimally invasive approach to treat HH and gradually become a first-line treatment. In total, this study enrolled 47 consecutive HH patients that underwent one round of ablation. Patients were followed for at least one year. Patients’ medical records and surgical information were carefully reviewed, and univariate analyses were performed. Of the treated patients, 72.3% remained GS-free in this study, with an overall Engel class I rate of 68.1%. Long-term postoperative complications occurred in six patients. Factors associated with GS prognosis included Delalande classification (p = 0.033), HH volume (p = 0.01), and the ablation rate of the HH body (p = 0.035). The disconnection rate was 0.73 ± 0.14 in the Engel class Ia group as compared to 0.62 ± 0.13 in the Engel Ib–Engel IV group (p = 0.046). MRgLITT represents a safe and effective surgical procedure. Patients with larger or Delalande type IV HH may require multiple rounds of ablation. In addition to assessing the degree of disconnection, ablation volume should also be carefully considered for patients undergoing this procedure. MDPI 2022-11-06 /pmc/articles/PMC9658093/ /pubmed/36362807 http://dx.doi.org/10.3390/jcm11216579 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yao, Yuan
Wang, Xiu
Hu, Wenhan
Zhang, Chao
Sang, Lin
Zheng, Zhong
Mo, Jiajie
Liu, Chang
Qiu, Jiaji
Shao, Xiaoqiu
Zhang, Jianguo
Zhang, Kai
Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes
title Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes
title_full Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes
title_fullStr Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes
title_full_unstemmed Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes
title_short Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Hypothalamic Hamartoma: Surgical Approach and Treatment Outcomes
title_sort magnetic resonance-guided laser interstitial thermal therapy for hypothalamic hamartoma: surgical approach and treatment outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9658093/
https://www.ncbi.nlm.nih.gov/pubmed/36362807
http://dx.doi.org/10.3390/jcm11216579
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