924 Corpus Callosotomy for Intractable Epilepsy: A Contemporary Series of Operative Factors and Overall Complication Rate

INTRODUCTION: Corpus callosotomy is an effective treatment for atonic seizures in medically refractory epilepsy. Recently, laser interstitial thermal therapy has been adapted as a less invasive method to achieve similar results, yet technical challenges associated with this nascent approach persist. A modern series of corpus callosotomies performed by open craniotomy is lacking in the literature, a fact which highlights the importance of establishing contemporary complication rates for this operation to compare with newer methodologies. METHODS: We retrospectively reviewed institutional data for patients who underwent first time open callosotomy from 2005 to 2022. Demographic and clinical variables were collected and analyzed with a focus on operative factors and complication rates. RESULTS: 105 patients were included in the study with a mean age of 9.39 years (0.67-24.17 years). 58.1% of patients were male (61), and one surgeon performed a majority (76.20%, 80) of the operations with two other surgeons performing the remainder (21.9% and 1.90%, respectively). In total, 63 complete, 31 subtotal (anterior 70-99%), and 1 posterior (40%) callosotomies were performed. Blood loss was available for 102/105 patients with a mean of 96.67 mL (10-500 mL), and mean operative time was calculated as 226.76 minutes (45-504 minutes) from 76/105 patients by excluding those patients who underwent concurrent vagal nerve stimulator placement or revision. Operative complication rate was determined to be 6.67% and was comprised of 3 pseudomeningoceles, 3 superficial wound infections, and 1 delayed intraparenchymal hemorrhage. No venous infarcts were observed on postoperative MRI. CONCLUSIONS: This the largest single center series of open callosotomy patients describes important updated metrics to help evaluate new techniques being developed for the surgical treatment of atonic seizures in medically intractable epilepsy.