Ozgural Onur, Kahilogullari Gokmen, Cinalli Giuseppe, Eroglu Umit, Dogan Ihsan, Al-Beyati Eyyub, Zaimoglu Murat, Unlu Agahan
Ankara University School of Medicine, Department of Neurosurgery, Ankara, Turkey.
Turk Neurosurg. 2020;30(1):23-29. doi: 10.5137/1019-5149.JTN.25698-19.1.
To evaluate the efficacy of using a neuronavigation system for demonstrating the relationship between the basilar artery (BA) and ventricular floor during endoscopic third ventriculostomy (ETV).
Records of 28 patients (16 females and 12 males) diagnosed with obstructive hydrocephalus who had undergone a neuroendoscopic procedure were retrospectively examined. Patient age ranged from 1 to 76 years (median 24.46 years). The BA was marked with using the neuronavigation system in all cases to visualise its relationship to the floor of the third ventricle in real time.
ETV was successfully performed in 28 patients with obstructive hydrocephalus. Of these, 13 (46.4%) patients had a thickened tuber cinereum (TC) membrane and 3 (10.7%) showed lateralization of the BA under the ventricular floor. No contact with the BA or related complications (e.g., major bleeding) was encountered with BA marking by using neuronavigation.
Even though thickening of the TC membrane and/or displacement of the BA might be seen otherwise, we describe a new method that combines marking the BA and using neuronavigation to provide greater safety in the area where the ventriculostomy will be performed. This permits clearer orientation for the surgeon which significantly contributes to minimizing surgical morbidity.
评估在神经内镜下第三脑室造瘘术（ETV）中使用神经导航系统来显示基底动脉（BA）与脑室底部之间关系的疗效。
回顾性检查了28例诊断为梗阻性脑积水且接受过神经内镜手术患者（16例女性和12例男性）的记录。患者年龄范围为1至76岁（中位数24.46岁）。所有病例均使用神经导航系统标记BA，以实时观察其与第三脑室底部的关系。
28例梗阻性脑积水患者成功实施了ETV。其中，13例（46.4%）患者的灰结节（TC）膜增厚，3例（10.7%）显示BA在脑室底部下方有侧移。使用神经导航标记BA时，未遇到与BA的接触或相关并发症（如大出血）。
尽管可能会出现TC膜增厚和/或BA移位等情况，但我们描述了一种新方法，即结合标记BA和使用神经导航，以在进行脑室造瘘术的区域提供更高的安全性。这为外科医生提供了更清晰的定位，显著有助于将手术发病率降至最低。
