LAUSR

Dear Editor, We read with great interest the recent article published by Desai et al., in your esteemed journal. The authors have shared their experience with laser ablation of subependymal giant cell astrocytoma (SEGA) using frameless stereotactic guidance in three patients [1]. The stereotactic ablation (SA), be it using laser, radiofrequency, or ultrasonic waves, provides us with a safe, minimally invasive and efficacious option in successfully treating lesions located deep inside the brain. These options have been extensively used in the management of drug refractory epilepsy especially hypothalamic hamartomas (HHs), heterotopias, focal cortical dysplasias (FCD-Type-IIb), and also tubers in patients of tuberous sclerosis [2–4]. With the exception of the tubers, the rest of the other lesions might be often inaccessible to the open surgery carrying greater morbidity and mortality. LITT has been extensively used to treat high-grade gliomas [4] (nonsurgical candidates and recurrent gliomas) and recently in low-grade gliomas (LGGs) with reasonable success although limited to case reports [4]. Hence, SA is unique in terms of being minimally invasive and having lower morbidity and equal efficacy compared with the open surgery. SA technique can be used in the following scenarios: