Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan.
Br J Neurosurg. 2024 Aug;38(4):1016-1019. doi: 10.1080/02688697.2021.1988053. Epub 2021 Oct 7.
Recent advances in neuroendoscopic surgery have led to the minimally invasive treatment of brain abscesses using various endoscopy techniques. The endoscopic diving technique (EDT) involving the formation of fluid lenses to improve the visibility of the endoscope has been reported to be useful in the endoscopic endonasal approach (EEA) for pituitary and midline cranial base lesions. Here, we report a case of brain abscess treated endoscopically using EDT in cylinder surgery.
A 29-year-old man with 11q trisomy syndrome developed a fever and progressive right hemiparesis was observed. A diagnosis of a brain abscess was made based on neuroradiological imaging, and endoscopic irrigation and drainage with EDT via a transparent endoscopic sheath were performed, which provided a clear operative field and allowed satisfactory irrigation without bacterial contamination. The bacterium identified by PCR was , and antibiotic therapy was administered. Postoperatively, his symptoms gradually improved.
This is the first technical case report describing the clinical experience of EDT in brain abscess surgery. EDT may be a useful technique not only in EEA but also in cylinder surgery for brain abscesses.
神经内镜手术的最新进展使得可以使用各种内镜技术对脑脓肿进行微创治疗。内镜潜水技术（EDT）涉及形成液透镜以提高内镜的可视性，已被报道在经鼻内镜入路（EEA）治疗垂体和中线颅底病变中有用。在这里，我们报告了一例使用 EDT 在圆柱手术中进行内镜治疗的脑脓肿病例。
一名 29 岁的 11q 三体综合征男性患者出现发热和进行性右侧偏瘫。神经影像学检查诊断为脑脓肿，通过透明内镜鞘进行内镜冲洗和 EDT 引流，提供了清晰的手术视野，并允许满意的冲洗而无细菌污染。通过 PCR 鉴定的细菌为 ，并给予抗生素治疗。术后，他的症状逐渐改善。
这是首例描述 EDT 在脑脓肿手术中临床经验的技术病例报告。EDT 不仅在 EEA 中，而且在脑脓肿的圆柱手术中也可能是一种有用的技术。
