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HHUGS In the News HH Surgery Down Under |
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For the past few years, the neurology team of the Children’s Epilepsy Program at the Royal Children’s Hospital (RCH), Melbourne have been developing and performing a new approach to removing hypothalamic hamartomas (HH). Previous HH surgery, approaching the HH from below, have been considered too risky and relatively ineffective in removing such tumors. The Melbourne team has been headed by the Director of the Children's Epilepsy Program, Dr Simon Harvey, and neurosurgeon Professor Jeffrey Rosenfeld. Professor Rosenfeld's technique involves entering through the top of the head, between the two halves of the brain and into a fluid filled sac called the third ventricle. This is where the HH sits and the neurosurgeon is able to get a good view of it using the latest navigational microsurgery techniques. This transcallosal (TC) approach gives a greater chance of total HH removal, and hence increase the likelihood that there will be a reduction (perhaps even a complete eradication) in seizure activity. The following diagram was featured in Melbourne's Herald Sun newspaper and provides a good overview of the TC approach.
You can download the full article, which describes the
procedure in detail and introduces the team from the RCH here (files are
in .pdf format): Read Prof Rosenfeld's paper "Epilepsy surgery, hypothalamic hamartomas and the quest for a cure" here. This paper was delivered as the King James IV lecture at the Royal Australasian College of Surgeons conference in Adelaide, Australia in May 2002. HH resections took place at the RCH between 1997 and 2002. During this time, around 30 children benefited from this pioneering surgical procedure. Families travelled to Australia from as far away as the United States, Hong Kong, Singapore, Tanzania, Germany, Mongolia and the United Kingdom to undergo this operation. You can read about the outcomes of some of these surgeries in our media section, here. HH surgeries on international patients at the RCH ceased in May 2002, however plans are now underway for Prof Rosenfeld to travel overseas so that neurosurgeons in other countries can observe first-hand this pioneering procedure. Already Prof Rosenfeld has operated on children and adults in Singapore and United Kingdom and it is hoped similar opportunities will soon emerge for residents of other countries, including the United States. In the meantime, HH surgeries on Australian children continue at the RCH under the Director of Neurosurgery, Miss Wirginia Maixner. The HH surgeries are also the subject of a paper which was published in the January 2001 issue of the journal Neurosurgery. You can read this article here. Click here to read a paper by Dr Harvey, Prof Rosenfeld and Liz Grimmer (Epilepsy Nurse Specialist at RCH) entitled "Information for Patients, Parents and Treating Doctors about Surgical Treatment of Hypothalamic Hamartomas in Children with Gelastic Epilepsy". This gives a good summary of the team's surgical procedure. Thanks to Jill Maben for the link! You can read about the new research study currently underway at RCH on HH and gelastic epilepsy here.
Professor Rosenfeld with two of his HH
success stories
Professor Rosenfeld with the Summerlins and
the Faulkners
Link to Children's Epilepsy Website |
