P17.30.B CLINICAL OUTCOMES OF REFINED TEMPORAL-TO-FRONTAL HORN SHUNTING FOR TUMOR-RELATED TRAPPED TEMPORAL HORN: A TWO-CENTER LONGITUDINAL STUDY

Abstract BACKGROUND Trapped temporal horn syndrome (TTH) is a rare form of obstructive hydrocephalus that frequently develops as a postoperative complication following intraventricular tumor resection. Due to its anatomical isolation and loculated CSF accumulation, long-term management remains challenging. This study aimed to evaluate the long-term outcomes and complication management of refined temporal-to-frontal horn shunting (RTFHS) in patients with tumor-related TTH. MATERIAL AND METHODS This retrospective case series included 53 consecutive patients with imaging-confirmed TTH secondary to prior brain tumor surgery, treated at two neurosurgical centers between January 2018 and January 2025. Patients presented with symptoms such as headache, cognitive decline, or motor deficits. All underwent RTFHS using ipsilateral, contralateral, or bilateral shunting approaches. Follow-up durations ranged from 1 month to 6 years, with 28 patients followed for over 6 months and 18 for over 1 year. Primary outcomes included clinical symptom improvement and reduction in temporal horn volume. Secondary outcomes focused on the management of complications such as high-protein CSF, infection, or shunt rejection. RESULTS The initial shunt patency rate was 86.8%, and the overall clinical success rate reached 98.1%. The mean temporal horn volume decreased by 30.0% on the day of surgery and by 60.3% at 3 months. LOWESS regression analysis demonstrated a rapid decline in the first week, followed by a gradual decrease over the next three months and subsequent stabilization. Long-term follow-up revealed no recurrence or re-enlargement in most patients. Complications were effectively managed in nearly all cases. CONCLUSION RTFHS is a safe, adaptable, and effective surgical strategy for managing tumor-related TTH. It provides sustained symptomatic and radiological improvement and may serve as a viable alternative to conventional ventriculo-peritoneal shunting in selected cases. This study also offers valuable insights into the prevention and management of perioperative complications in post-tumor resection hydrocephalus.