摘要
目的：复习颞叶的局部解剖，探讨颞叶切除方法的改进。方法：（１）手术技巧的改进：①首先寻找侧脑室颞角；②经颞上回切除颞叶外侧皮质；③在直视下切除颞叶内侧结构（杏仁、海马、钩回及海马旁回等）。（２）在ＥＣｏＧ监测下，反复描记ＥＣｏＧ，尽可能切除致痫组织。结果：满意者３８％，显著改善者占４０％，良好者占１０％，效差６％，无改善者６％。并发症：偏瘫加重１例，无菌性脑膜炎３例，记忆力下降４例，无手术死亡。结论：熟悉颞叶解剖，应用改进的颞叶切除法，术后的并发症少。
Object: Review anatomy of the temporal lobe and study modified technique of temporal lobectomy. Method: First, The procedure is carried out in three step: (1) Transcortical (T 2 Middlegyrus) approach to the temporal horn of the lateral ventricle. (2) The resection of Anterior temporal lateral cortical is performed along the first temporal gyrus to the fusiform gyrus. (3) Medial temporal lobe siructures of resection which include the amygdala, the hippocampus, the uncal gyrus and parahippocampus is done. next: ECoG (Electrocorticography) is used to delineate the epileptic areas and to evaluatee the amount of residual activity in view of further resection. Result: (1) Satisfactory outcome in 38.2%, (2) Marked improvement in 39.6%, (3) Improvement in 10%, (4) Slight improvement and no improvement in 12%. in series, complications of surgery include hemiplegia in 1 case, aseptic meningitis in 3 cases. and memory deficits in 3 cases. Conclusion: The authour feel that Anatomy of temporal lobe should be identify accurately and used Modified anterior temporal lobectomy, Postoperative Complications is reduced and stop seizure's outcome wree considered favorable.
