RESUMEN
To explore the advantages and disadvantages of 3D Slicer reconstruction and 3D printing localization combined with transcranial neuroendoscope in the surgical treatment of deep cerebral micro cavernous hemangiomas. Method The clinical data of patients with deep cerebral micro cavernous hemangiomas treated by our hospital from June 2022 to February 2023 using 3D Slicer reconstruction and 3D printing localization technology combined with transcranial endoscopic surgery were retrospectively analyzed. A total of 5 cases with complete data were collected, including 2 males and 3 females, aged 9-59 years. All 5 patients had deep supratentorial cavernous hemangiomas with a diameter of less than 1.5 cm, and had clinical symptoms such as headache or epilepsy, and had been diagnosed by CT or MRI. Repeated bleeding from small cavernous hemangiomas in the deep brain can lead to clinical symptoms such as recurrent headache and epilepsy, and is required surgical treatment. However, cavernous hemangiomas often have smaller lesions and are difficult to locate in the deep part. Without neuronavigation, surgery can become extremely difficult. Our team's newly developed 3D Slicer reconstruction and 3D printing localization technology which could provide new options for surgical treatment of small cavernous hemangiomas or other small lesions in the deep brain, but its accuracy and safety still need to be verified by further clinical research.
Asunto(s)
Neuroendoscopía , Impresión Tridimensional , Humanos , Femenino , Masculino , Adulto , Adolescente , Niño , Persona de Mediana Edad , Neuroendoscopía/métodos , Estudios Retrospectivos , Adulto Joven , Hemangioma Cavernoso del Sistema Nervioso Central/cirugía , Hemangioma Cavernoso del Sistema Nervioso Central/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Imagenología Tridimensional/métodos , Neoplasias Encefálicas/cirugía , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/patología , Hemangioma Cavernoso/cirugía , Hemangioma Cavernoso/diagnóstico por imagen , Hemangioma Cavernoso/patología , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: To explore the surgical techniques, advantages, and disadvantages of neuroendoscopic telovelar approach in the treatment of brainstem and fourth ventricle lesions. METHODS: The clinical data of 5 patients treated by neuroendoscopic telovelar approach from March 2020 to March 2022 were analyzed retrospectively. RESULTS: Among the 5 patients, there were 3 cavernous hemangiomas in pontine arm and 2 tumors in brainstem and fourth ventricle. All patients could successfully complete the operation, and 4 patients recovered well, other 1 patient discharged automatically for serious complications of other systems after the operation. CONCLUSION: The telovelar approach has gained popularity as a safe and effective strategy for lesions in fourth ventricular and brainstem. However, without removing the posterior arch of the atlas, it is difficult to enter the upper part of the fourth ventricle under a microscope. Transcranial neuroendoscopy can effectively compensate for the shortcomings of microscopy, whether used as an auxiliary measure for microsurgery or alone with proficient endoscopic techniques, it will provide greater application in minimally invasive surgery for fourth ventricle and brainstem lesions. By utilizing the excellent degree of freedom of transcranial neuroendoscopy, there is no need to open the posterior arch of the atlas, making the surgery more minimally invasive. However, the sample size of this study is small, and it was completed under the very mature neuroendoscopic technology of our team. Its general safety and practicality still require extensive clinical research validation.
Asunto(s)
Neuroendoscopía , Humanos , Neuroendoscopía/métodos , Cuarto Ventrículo/cirugía , Procedimientos Neuroquirúrgicos/efectos adversos , Estudios Retrospectivos , Tronco Encefálico/cirugíaRESUMEN
OBJECTIVE: To evaluate the effectiveness and safety of neuroendoscopic surgery for chronic or subacute subdural hematoma. PATIENTS AND METHODS: Between September 2016 and September 2018, neuroendoscopic surgery was performed on 25 patients with chronic and subacute subdural hematoma. Hematoma evacuation was performed with a 0°, 4 mm diameter rigid neuroendoscope via a transcranial neuroendoscopic approach. RESULTS: All patients successfully underwent neuroendoscopic surgery, and no surgical complications or rebleeding was observed. Postoperative computed tomography scans showed that the hematoma was successfully evacuated. All patients had recovered well at discharge, the observed 30-day mortality rate was 0%, and no patients suffered recurrence for 2-26 months after surgery. CONCLUSION: Neuroendoscopic surgery was a safe and effective approach for the treatment of chronic and subacute subdural hematoma. This approach has the advantages of decent visualization and minimal invasiveness and could reduce recurrence and the mortality rate.