Keyhole Approaches for Deep-Seated Lesions

Abstract The current literature has shown a clear survival advantage by achieving a radical or as near complete a resection as possible for all grades of gliomas. Challenges arise when gliomas are deep-seated within the brain. With keyhole and neuroendoscopic surgical techniques, deep-seated gliomas can be addressed confidently. Here, we discuss keyhole techniques using five specific tumors as examples of many of the concerns associated with the ability to achieve a radical resection: insular gliomas, mesial temporal gliomas, brain stem gliomas, butterfly gliomas, and thalamic gliomas. An illustrative case is provided for each deep-seated lesion. With the application of the keyhole and neuroendoscopic techniques, a thorough resection of deep-seated gliomas can be obtained with minimal added morbidity from the surgical approach.