Comparative Anatomical Study on Operability in Surgical Approaches to the Anterior Part of the Third Ventricle

Alfio Spina, Filippo Gagliardi, Michele Bailo, Nicola Boari, Anthony J. Caputy, Pietro Mortini

Research output: Contribution to journalArticlepeer-review


Background Surgery of the third ventricle still represents a challenge in modern neurosurgery. To optimize the surgical planning, some aspects, related to ventricular anatomy, have to be taken into consideration. An operability score could represent a preoperative tool to evaluate these variables to choose a tailored surgical approach. Methods We compared the transcallosal transforaminal approach and the combined interhemispheric subcommissural translamina terminalis approach (CISTA) to the anterior part of the third ventricle, applying the operability score. Results Compared with the transcallosal transforaminal approach, the CISTA provides a statistically significant improvement in terms of depth of surgical field, surgical angle of attack, and maneuverability arc considering as 4 approach-related critical structures: the optic chiasm (P value: <0.0001, <0.0001, <0.0001, respectively), the anterior commissure (P value: <0.0001, <0.0001, <0.0001 respectively), the tuber cinereum (P value: <0.0001, 0.0224, 0.0173), and the interthalamic adhesion (P value: 0.2917, <0.0001, <0.0001 respectively). Conclusions Tumors originating from the anterosuperior part of the third ventricle can be easily approached through a transcallosal transforaminal route, whereas lesions arising from the anteroinferior portion of the third ventricle might be safely and effectively approached through the CISTA.

Original languageEnglish
Pages (from-to)2-5
Number of pages4
JournalWorld Neurosurgery
Publication statusPublished - Nov 1 2016


  • Corpus callosum
  • Lamina terminalis
  • Operability score
  • Optic chiasm
  • Third ventricle

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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