Tish Shahed, Habboub Ghaith, Borghei-Razavi Hamid, Woodard Troy D, Sindwani Raj, Kshettry Varun R, Recinos Pablo F
Minimally-Invasive Cranial Base and Pituitary Surgery Program, Rose Ella Burkhardt Brain Tumor & Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio, United States.
Department of Neurological Surgery, Section of Skull Base Surgery, Cleveland Clinic, Cleveland, Ohio, United States.
J Neurol Surg B Skull Base. 2021 Mar 9;83(3):312-316. doi: 10.1055/s-0040-1721820. eCollection 2022 Jun.
Radiofrequency ablation is widely utilized in otorhinolaryngology. It is used for ablation, coagulation and resection, and hemostasis. It causes tissue destruction through a chemical interaction of ions. The potential benefit is to cause less thermal injury to surrounding tissues compared with other coagulative tools. In this article, we present novel uses of radiofrequency ablation in endoscopic endonasal, and transcranial surgery. This is the first study to describe its use in transcranial cases. This is a retrospective study of patients between 2016 and 2018 who underwent either endoscopic endonasal or transcranial surgery where radiofrequency ablation was used. We looked at indication for usage, blood loss, postoperative imaging to identify any stroke or edema, and clinical outcomes of these patients. The radiofrequency device was used in eight endoscopic endonasal cases and four craniotomies. Four cases were for encephalocele repair and eight were for various intracranial pathologies. In endonasal encephalocele repair, the radiofrequency ablation helped in shrinking the herniated brain while minimizing thermal injury to the surrounding tissue. In tumors resection, the combination of ablation and coagulation effect was particularly effective for highly vascularized tumors. There were no vascular or major neurologic injuries. Postoperative periencephalocele edema was noted in one case. Initial experience with radiofrequency ablation showed that it was a safe technique to use in both endonasal skull-base and transcranial procedures. It seemed particularly useful for highly vascularized tumors but a greater experience is needed to further clarify its role in these procedures.
射频消融术在耳鼻咽喉科中得到广泛应用。它用于消融、凝固、切除和止血。它通过离子的化学相互作用导致组织破坏。与其他凝固工具相比，其潜在益处是对周围组织造成的热损伤较小。在本文中，我们介绍了射频消融术在内镜鼻内手术和经颅手术中的新用途。这是第一项描述其在经颅病例中应用的研究。
这是一项对2016年至2018年间接受内镜鼻内手术或经颅手术并使用射频消融术的患者的回顾性研究。
我们观察了这些患者的使用指征、失血量、术后影像学检查以确定是否有中风或水肿以及临床结果。
射频设备用于8例内镜鼻内手术病例和4例开颅手术。4例用于脑膨出修复，8例用于各种颅内病变。在鼻内脑膨出修复中，射频消融有助于缩小突出的脑组织，同时将对周围组织的热损伤降至最低。在肿瘤切除中，消融和凝固效果的结合对高度血管化的肿瘤特别有效。没有血管或重大神经损伤。1例患者术后出现脑膨出周围水肿。
射频消融术的初步经验表明，它是一种在内镜鼻颅底手术和经颅手术中使用的安全技术。它似乎对高度血管化的肿瘤特别有用，但需要更多经验来进一步阐明其在这些手术中的作用。
