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Posts Tagged ‘endoscopy

Ahead of Print: Keyhole STTCS Approach

Screen Shot 2013-04-29 at 9.33.03 AMBackground and Importance: Meningiomas of the lateral ventricles are commonly located in the atria. Surgical access to such tumors is challenging because of their deep location and proximity to critical neurovascular structures, particularly if situated on the dominant side. Although a number of approaches have been described in the literature, most carry the risk of post-operative neuropsychological, visual or speech deficits, especially when operating on the dominant hemisphere. The supracerebellar transtentorial transcollateral sulcus (STTCS) approach offers the potential to circumvent functionally important structures, reducing the risk of these approach-related neurological deficits.

Clinical Presentation: Two patients with dominant hemisphere trigonal meningiomas underwent surgical resection utilizing the STTCS approach. Neuronavigation was used to carefully plan the incision, craniotomy and exposure, and also intra-operatively to orientate the operating surgeon at key steps, particularly when raising the tentorial flap in-line with the tumor. Endoscopy was used to provide increased light intensity, an extended viewing angle, and higher magnification when compared to a microscope. Specially designed tube-shaft instruments were also employed to assist with manipulation through the narrow surgical corridor. In both cases the tumors were fully resected without approach-related morbidity.

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Written by NEUROSURGERY® Editorial Office

September 5, 2013 at 2:00 PM

Ahead of Print: Endoscopic Colloid Cyst Resection in the Absence of Ventriculomegaly

Screen Shot 2013-04-19 at 7.34.20 AMBackground: The absence of ventriculomegaly has been considered an overt or relative contraindication to the endoscopic resection of colloid cysts. In the past, endoscopic removal of colloid cysts in the absence of ventriculomegaly has been considered ill advised. Reports of successful endoscopic surgery in small ventricles are surfacing

Objective: We examined the combined experience of 2 high-volume endoscopic centers to characterize the outcomes of patients undergoing endoscopic removal of colloid cysts in small ventricles.

Methods: We retrospectively reviewed all endoscopic colloid cyst removal procedures by the 2 senior authors (PN, CT) performed at the Barrow Neurological Institute over an 8-year period. Radiographic, clinical, and interview data were recorded and analyzed. The age-adjusted relative bicaudate index was used to define “small ventricles.”

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Written by NEUROSURGERY® Editorial Office

April 19, 2013 at 8:00 AM

Free Article: Endoscopy in Aneurysm Surgery

Background: Surgical clipping with complete occlusion of the aneurysm and preservation of parent, branching, and perforating vessels remains the most definitive treatment for intracranial aneurysms.

Objective: To evaluate the benefit of endoscopic application during microsurgical procedures in a retrospective study.

Methods: One hundred eighty aneurysms were microsurgically treated in 124 operations. Three different applications of endoscopic visualization were used, depending on the respective requirements: inspection before clipping, clipping under endoscopic view, and postclipping evaluation.

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Written by NEUROSURGERY® Editorial Office

May 25, 2012 at 7:41 AM

Ahead of Print: Endoscopic Middle Cranial Fossa Reconstruction

Background: Reconstruction of the skull base is essential to prevent postoperative leakage of cerebrospinal fluid (CSF). However, a reliable method of reconstructing the middle cranial fossa via a subtemporal keyhole is not available.

Objective: To determine whether less invasive reconstruction of the middle cranial fossa under endoscopic guidance using a pedicled deep temporal fascia approach via a subtemporal keyhole is feasible and useful.

Methods: The middle cranial fossa in four fresh cadaver heads was reconstructed using a 4-mm 0[degrees] rigid endoscope.

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Written by NEUROSURGERY® Editorial Office

February 15, 2012 at 7:44 AM

Video: Supraorbital Endoscopic Approach to Colloid Cyst

This video demonstrates a supraorbital endoscopic approach to colloid cyst in the third ventricle.
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Written by NEUROSURGERY® Editorial Office

November 16, 2011 at 8:00 AM

Video: The Endoscopic Diving Technique in Pituitary and Skull Base Surgery

This video demonstrates surgical applications of the diving technique.

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Written by NEUROSURGERY® Editorial Office

August 3, 2011 at 9:00 AM

Video: Intracranial Cysts Containing CSF-like Fluid: Results of Endoscopic Neurosurgery Video 4

This video demonstrates that the endoscopic fenestrations may be as wide and extended as the microsurgical ones. As soon as the neurovascular structures are identified, the arachnoid dissection is conducted in the optico-carotid cistern with the progressive exposure of optic nerve, ICA, MCA, and ACA.

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Written by NEUROSURGERY® Editorial Office

May 4, 2011 at 8:34 AM


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