Liu James K, Dodson Vincent N
Department of Neurological Surgery, Center for Cerebrovascular and Skull Base Surgery, Neurological Institute of New Jersey, Rutgers University, New Jersey Medical School, RWJ Barnabas Health, Newark and Livingston, New Jersey.
Neurosurg Focus Video. 2019 Oct 1;1(2):V13. doi: 10.3171/2019.10.FocusVid.19413. eCollection 2019 Oct.
Cervicomedullary gangliogliomas are rare low-grade neoplasms of the brainstem. They can be challenging lesions to resect due to the eloquent location in the brainstem. In some instances, the absence of a clear surgical plane between the tumor and normal neural tissue can prohibit a complete resection. Therefore, it is important to leave a thin rim of residual tumor at the tumor-brainstem interface in order to avoid irreversible neurological injury. In this operative video, the authors demonstrate the technique to develop a surgical pseudoplane using sharp microdissection for a cervicomedullary brainstem ganglioglioma without a clear interface between the tumor and normal neural tissue. This strategy allowed for radical near-total resection of the tumor, thereby maximizing the extent of removal while preserving neurological function. Postoperatively, the patient had normal neurological function and returned to work without any disability. In summary, due to the lack of a clear surgical dissection plane, a pseudoplane near the surgical interface can be performed using sharp dissection to facilitate radical near-total resection. The video can be found here: https://youtu.be/biD4G1Hh0yk.
颈髓神经节胶质瘤是脑干罕见的低级别肿瘤。由于其位于脑干的功能区，它们可能是具有挑战性的可切除病变。在某些情况下，肿瘤与正常神经组织之间缺乏清晰的手术平面可能会妨碍完整切除。因此，在肿瘤与脑干界面处留下一层薄薄的残留肿瘤边缘很重要，以避免不可逆转的神经损伤。在本手术视频中，作者展示了一种使用锐性显微解剖技术为颈髓脑干神经节胶质瘤建立手术假平面的方法，该肿瘤与正常神经组织之间没有清晰的界面。这种策略允许对肿瘤进行根治性近全切除，从而在保留神经功能的同时最大限度地扩大切除范围。术后，患者神经功能正常，恢复工作且无任何残疾。总之，由于缺乏清晰的手术分离平面，可以使用锐性解剖在手术界面附近形成一个假平面，以促进根治性近全切除。视频链接：https://youtu.be/biD4G1Hh0yk 。
