Oertel Joachim, Krauss Joachim Kurt, Gaab Michael Robert
Department of Neurosurgery, Hannover Nordstadt Hospital, Germany.
J Neurosurg. 2008 Nov;109(5):908-11. doi: 10.3171/JNS/2008/109/11/0908.
Neuroendoscopic techniques are often considered inapplicable to lesion resection because most lesions are too large for effective endoscopic resection in an appropriate time frame. To evaluate the potential of ultrasonic aspiration in neuroendoscopic procedures, the authors developed a new handpiece for endoscopic application. The instrument was subsequently tested in 10 cadaveric pig brains and applied in 5 clinical cases. In the pig brain, a precise and accurate aspiration of ventricular ependyma and brain parenchyma was obtained. Clinically, the device was applied in 3 patients with obstructive hydrocephalus, and via an endonasal transsphenoidal approach in 2 patients with pituitary macroadenomas. In all cases, the lesion was effectively aspirated without complications. Ultrasonic aspiration can be applied safely and successfully in selected endoscopic procedures. The use of this technique could expand the indications for endoscopic approaches to include intraventricular lesions and in minimally invasive transsphenoidal endonasal approaches.
神经内镜技术通常被认为不适用于病变切除，因为大多数病变太大，无法在合适的时间框架内进行有效的内镜切除。为了评估超声吸引在神经内镜手术中的潜力，作者开发了一种用于内镜应用的新手持器械。该器械随后在10个猪尸体脑上进行了测试，并应用于5例临床病例。在猪脑中，实现了对脑室室管膜和脑实质的精确抽吸。临床上，该设备应用于3例梗阻性脑积水患者，通过鼻内经蝶入路应用于2例垂体大腺瘤患者。在所有病例中，病变均被有效抽吸，无并发症发生。超声吸引可安全、成功地应用于特定的内镜手术。该技术的应用可以扩大内镜手术适应证，包括脑室内病变以及微创经鼻蝶入路手术。
