Fluorescence guidance in skull base surgery: Applications and limitations – A systematic review

IF 1.9 Q3 CLINICAL NEUROLOGY Brain & spine Pub Date : 2024-01-01 DOI:10.1016/j.bas.2024.103328
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引用次数: 0

Abstract

Introduction

Intraoperative fluorescence guidance is a well-established surgical adjunct in high-grade glioma surgery. In contrast, the clinical use of such dyes and technology has been scarcely reported in skull base surgery.

Research question

We aimed to systematically review the clinical applications of different fluorophores in both open and endonasal skull base surgery.

Material and methods

We performed a systematic review and discussed the current literature on fluorescence guidance in skull base surgery.

Results

After a comprehensive literature search, 77 articles on skull base fluorescence guidance were evaluated. A qualitative analysis of the articles is presented, discussing clinical indications and current controversies. The use of intrathecal fluorescein was the most frequently reported in the literature. Beyond that, 5-ALA and ICG were two other fluorescent dyes most extensively discussed, with some experimental fluorophore applications in skull base surgery.

Discussion and conclusion

Intraoperative fluorescence imaging can serve as an adjunct technology in skull base surgery. The scope of initial indications of these fluorophores has expanded beyond malignant glioma resection alone. We discuss current use and controversies and present an extensive overview of additional indications for fluorescence imaging in skull base pathologies. Further quantitative studies will be needed in the future, focusing on tissue selectivity and time-dependency of the different fluorophores currently commercially available, as well as the development of new compounds to expand applications and facilitate skull base surgeries.

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颅底手术中的荧光引导:应用和局限性 - 系统综述
导言术中荧光引导是高级别胶质瘤手术中一种行之有效的手术辅助手段。研究问题我们旨在系统回顾不同荧光剂在开放性和腔内颅底手术中的临床应用。材料和方法我们对颅底手术中荧光引导的现有文献进行了系统回顾和讨论。本文对这些文章进行了定性分析,讨论了临床适应症和目前存在的争议。文献中最常报道的是鞘内荧光素的使用。讨论与结论术中荧光成像可作为颅底手术的辅助技术。这些荧光染料的最初适应症范围已经超出了单纯的恶性胶质瘤切除术。我们讨论了当前的使用情况和争议,并对荧光成像在颅底病变中的其他适应症进行了广泛概述。未来还需要进一步的定量研究,重点关注目前市面上不同荧光团的组织选择性和时间依赖性,以及新化合物的开发,以扩大应用范围并促进颅底手术。
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来源期刊
Brain & spine
Brain & spine Surgery
CiteScore
1.10
自引率
0.00%
发文量
0
审稿时长
71 days
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