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Subfrontal Translamina Terminalis Approach

Last Updated: September 29, 2018

Resection of a Predominately Solid Third Ventricular Craniopharyngioma via the Subfrontal Translamina Terminalis Approach Using an Orbitozygomatic Craniotomy

General Considerations and Indications for the Approach

The lamina terminalis is a thin membrane composed of gray matter, pia mater, and ependyma bordered superiorly by the anterior commissure, laterally by the cerebral hemispheres and inferiorly by the superior aspect of the optic chiasm. Embryologically, this lamina represents the most rostral end of the developing neural tube.

The subfrontal translamina terminalis approach uses the anterior wall of the third ventricle (lamina terminalis) to reach anterior lesions in this chamber. I use this approach rarely, mainly for large predominately solid craniopharyngiomas and hypothalamic hamartomas. Cystic craniopharyngiomas are ideally exposed via the transnasal transtuberculum route.

The subfrontal approach for a solid third ventricul...