TRANSTRIGONE LATERAL VENTRICLE APPROACH FOR RESECTION OF POSTERIOR THIRD VENTRICLE TUMORS

Eighteen cases of posterior third ventricle tumor were operated by the transtrigone approach.Initially,we used Van Wagenents “L”shaped parieto-temporal cortical incision, which was often complicated by homonymous hemianopsia postoperatively.Then,a linear incision in the middle temporal gyrus or interparietal sulcus was employed,which scarcely results in damage to the optic radiation.Generally,the tumors were easily explored from inner wall of the trigone and could be radically resected.In this series,total resection was performed in 7 cases,subtotal in 7,and partial in 4.The pathological diagnosis was pinealoma in 6 cases,ependymoma in 5,malignant glioma in 3,cholesteatoma in 2,teratoma in 1 and meningioma in 1. The operative results were good in 5 patients,improved in 8,unchanged in 2 and deteriorated in 1.Two patients died postoperatively,making an operative mortality of 11.1%.Thirteen of these cases were followed up for 2 months to 10 years,during which 7 patients resumed to their work （3 full time,and 4 partial time）,3 could cared by themselves,and 3 were bed ridden. In this article,the advantages and disadvantages of this operative approach and the preventive measures for postoperative neurological deficits were discussed The authors believe that this modified Van Wagenen’s operative approach appears to be more ideal procedure for the resection of posterior third ventricle tumors.