Yang Meredith, Wolfson Daniel, LoPresti Melissa A, Poland Emma, Lam Sandi, DeCuypere Michael
1Pritzker School of Medicine, The University of Chicago, Chicago, Illinois.
2Department of Neurological Surgery, Rush University Medical Center, Chicago, Illinois.
J Neurosurg Case Lessons. 2023 Apr 17;5(16). doi: 10.3171/CASE22517.
Tectal region tumors often clinically present as obstructive hydrocephalus due to mass effect on the outflow of the third ventricle and cerebral aqueduct. Pathology in this region varies; thus, biopsy can be of great value in the management decision making. Appropriate instrumentation remains an area of interest to further advance flexible neuroendoscopic techniques and applications.
The authors report an illustrative case using flexible neuroendoscopy through a single burr hole for simultaneous endoscopic third ventriculostomy (ETV) and tectal tumor biopsy using urological cup forceps in a 13-year-old boy who had presented with obstructive hydrocephalus.
The authors demonstrate the feasibility of simultaneous ETV and tectal lesion biopsy via flexible neuroendoscopy to address obstructive hydrocephalus and obtain a tissue biopsy in a single-site procedure. They found that the use of flexible cup forceps designed for uroscopy is an important complement to flexible neuroendoscopy. Given the evolving applications of flexible neuroendoscopy, this has implications for instrumentation adaptation and future design.
顶盖区肿瘤临床上常因对第三脑室和中脑导水管流出道的占位效应而表现为梗阻性脑积水。该区域的病理情况各不相同；因此，活检在管理决策中可能具有重要价值。合适的器械仍然是进一步推进软性神经内镜技术及应用的一个关注领域。
作者报告了一例说明性病例，在一名出现梗阻性脑积水的13岁男孩中，通过单个钻孔使用软性神经内镜同时进行内镜下第三脑室造瘘术（ETV）和使用泌尿外科杯状钳进行顶盖区肿瘤活检。
作者证明了通过软性神经内镜同时进行ETV和顶盖区病变活检以解决梗阻性脑积水并在单部位手术中获取组织活检的可行性。他们发现，使用专为泌尿外科检查设计的软性杯状钳是软性神经内镜的重要补充。鉴于软性神经内镜的应用不断发展，这对器械适配和未来设计具有启示意义。
