A. Bertalanffy1, M. Aichholzer1, A. Reinprecht1, R. Brix3, A. Ertl1, K. Heimberger2, K. Kitz1
{"title":"An Intramural Macrocyst of an Acoustic Neurinoma Rupturing after Gamma Knife Radiosurgery: A Case Report","authors":"A. Bertalanffy1, M. Aichholzer1, A. Reinprecht1, R. Brix3, A. Ertl1, K. Heimberger2, K. Kitz1","doi":"10.1055/s-2001-16009","DOIUrl":"https://doi.org/10.1055/s-2001-16009","url":null,"abstract":"","PeriodicalId":49808,"journal":{"name":"Minimally Invasive Neurosurgery","volume":"43 1","pages":"110 - 113"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77129883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Recently, the use of intra-operative image guidance has gained an increasing role in neurosurgery for both spinal and cerebral interventions. Some modern neuronavigation systems are able to register any surgical instrument and create a virtual pointer. A virtual elongation of the digitized instrument is frequently used for neuroendoscopic procedures and spinal instrumentation. The instrument is equipped with a universal instrument adapter clamp and digitized by touching the tip of the instrument into a calibration cone. An algorithm calculates the vector of the instrument using two points: the tip of the instrument, and the geometrical center of the instrument adapter geometry. If a virtual elongation of the calibrated instrument is performed, the neuronavigation software may calculate an incorrect virtual target point. We developed an instrument calibration matrix (ICM) that automatically calibrates the correct vector, tip, and diameter of the instrument used for image-guided surgery. The ICM is easy to handle and does not cause a time delay during surgery. Virtual elongation of the surgical instruments shows correct anatomic data, which are fundamental for planning ventricular tapping and spinal screw placement in particular. The instrument calibration matrix is essential if surgical instruments are digitized and used for neuronavigation. It helps to avoid mis-planning of surgical vectors and mis-placement of the used instruments.
{"title":"Incorrect Vector after Calibration of Surgical Instruments for Image Guidance. The Problem and the Solution: Technical Note","authors":"U. Sure, D. Hellwig, H. Bertalanffy","doi":"10.1055/S-2001-16011","DOIUrl":"https://doi.org/10.1055/S-2001-16011","url":null,"abstract":"Recently, the use of intra-operative image guidance has gained an increasing role in neurosurgery for both spinal and cerebral interventions. Some modern neuronavigation systems are able to register any surgical instrument and create a virtual pointer. A virtual elongation of the digitized instrument is frequently used for neuroendoscopic procedures and spinal instrumentation. The instrument is equipped with a universal instrument adapter clamp and digitized by touching the tip of the instrument into a calibration cone. An algorithm calculates the vector of the instrument using two points: the tip of the instrument, and the geometrical center of the instrument adapter geometry. If a virtual elongation of the calibrated instrument is performed, the neuronavigation software may calculate an incorrect virtual target point. We developed an instrument calibration matrix (ICM) that automatically calibrates the correct vector, tip, and diameter of the instrument used for image-guided surgery. The ICM is easy to handle and does not cause a time delay during surgery. Virtual elongation of the surgical instruments shows correct anatomic data, which are fundamental for planning ventricular tapping and spinal screw placement in particular. The instrument calibration matrix is essential if surgical instruments are digitized and used for neuronavigation. It helps to avoid mis-planning of surgical vectors and mis-placement of the used instruments.","PeriodicalId":49808,"journal":{"name":"Minimally Invasive Neurosurgery","volume":"11 1","pages":"88 - 91"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91070762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Endoscopic surgery may play an important role in most patients with pineal region tumors. We report our experience with 5 patients treated by a burr hole endoscopic technique. The procedure included in all cases third ventriculostomy for the correction of hydrocephalus, CSF sample for cytology and tumor markers, and tumor biopsy for histological diagnosis. Endoscopic biopsies showed a pineocytoma in two cases, a germinoma in 2 and a low-grade astrocytoma in one. We agree that endoscopic surgery may allow us to select cases requiring a microsurgical approach (medium-sized or large non-germ-cell tumors) from cases to be treated only by irradiation and chemotherapy (germinomas and other non-germ-cell tumors). Then, in some patients with pineal region tumors the endoscopic procedure remains the only surgical treatment. When a direct microsurgical approach is indicated, it may be performed in a non-emergency situation and after correction of the hydrocephalus by endoscopic third ventriculostomy.
{"title":"Endoscopic Surgery for Pineal Region Tumors","authors":"M. Gangemi, F. Maiuri, G. Colella, S. Buonamassa","doi":"10.1055/s-2001-16002","DOIUrl":"https://doi.org/10.1055/s-2001-16002","url":null,"abstract":"Endoscopic surgery may play an important role in most patients with pineal region tumors. We report our experience with 5 patients treated by a burr hole endoscopic technique. The procedure included in all cases third ventriculostomy for the correction of hydrocephalus, CSF sample for cytology and tumor markers, and tumor biopsy for histological diagnosis. Endoscopic biopsies showed a pineocytoma in two cases, a germinoma in 2 and a low-grade astrocytoma in one. We agree that endoscopic surgery may allow us to select cases requiring a microsurgical approach (medium-sized or large non-germ-cell tumors) from cases to be treated only by irradiation and chemotherapy (germinomas and other non-germ-cell tumors). Then, in some patients with pineal region tumors the endoscopic procedure remains the only surgical treatment. When a direct microsurgical approach is indicated, it may be performed in a non-emergency situation and after correction of the hydrocephalus by endoscopic third ventriculostomy.","PeriodicalId":49808,"journal":{"name":"Minimally Invasive Neurosurgery","volume":"85 1","pages":"70 - 73"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81083261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Unger, C. Walch, Heinz Stammberger, G. Papaefthymiou, K. Haselsberger, G. Pendl
Microsurgical techniques have considerably improved the results of surgical treatment for esthesioneuroblastoma (olfactory neuroblastoma). Nevertheless, these rare tumours of the frontal skull base are still associated with high rates of tumour recurrence and mortality, thus remaining a challenge even for experienced surgeons. A novel therapeutic approach that combines endoscopic sinus surgery and radiosurgery (gamma knife) is presented here. Six patients (3 males, 3 females) aged between 27 and 75 years (median 38 years) were treated between August 1993 and July 1999. Following paranasal and nasal endoscopic sinus surgery, marginal irradiation doses ranging from 16 to 34 Gy were applied radiosurgically involving up to 7 isocentres. At present, the median follow-up period is 57 months (range: 9 - 79 months). Without mortality, tumour control was achieved in all patients. One patient, who had to undergo additional craniotomy because of extensive neoplastic infiltration, developed postoperative liquorrhea. In another case the clinical course was complicated by a bilateral frontal sinusitis. All patients complained of nasal discharge and crusts. However, a preoperative Karnovsky Index ranging from 80 to 100 % remained stable in four patients whereas an improvement was observed in two patients. Based on the favourable results observed so far, the combination of endoscopic sinus surgery and radiosurgery can be considered as promising new option for the treatment of esthesioneuroblastoma that merits further investigation.
{"title":"Olfactory Neuroblastoma (Esthesioneuroblastoma): Report of Six Cases Treated by a Novel Combination of Endoscopic Surgery and Radiosurgery","authors":"F. Unger, C. Walch, Heinz Stammberger, G. Papaefthymiou, K. Haselsberger, G. Pendl","doi":"10.1055/s-2001-16000","DOIUrl":"https://doi.org/10.1055/s-2001-16000","url":null,"abstract":"Microsurgical techniques have considerably improved the results of surgical treatment for esthesioneuroblastoma (olfactory neuroblastoma). Nevertheless, these rare tumours of the frontal skull base are still associated with high rates of tumour recurrence and mortality, thus remaining a challenge even for experienced surgeons. A novel therapeutic approach that combines endoscopic sinus surgery and radiosurgery (gamma knife) is presented here. Six patients (3 males, 3 females) aged between 27 and 75 years (median 38 years) were treated between August 1993 and July 1999. Following paranasal and nasal endoscopic sinus surgery, marginal irradiation doses ranging from 16 to 34 Gy were applied radiosurgically involving up to 7 isocentres. At present, the median follow-up period is 57 months (range: 9 - 79 months). Without mortality, tumour control was achieved in all patients. One patient, who had to undergo additional craniotomy because of extensive neoplastic infiltration, developed postoperative liquorrhea. In another case the clinical course was complicated by a bilateral frontal sinusitis. All patients complained of nasal discharge and crusts. However, a preoperative Karnovsky Index ranging from 80 to 100 % remained stable in four patients whereas an improvement was observed in two patients. Based on the favourable results observed so far, the combination of endoscopic sinus surgery and radiosurgery can be considered as promising new option for the treatment of esthesioneuroblastoma that merits further investigation.","PeriodicalId":49808,"journal":{"name":"Minimally Invasive Neurosurgery","volume":"50 1","pages":"79 - 84"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77143541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thecaloscopy: The Endoscopy of the Lumbar Subarachnoid Space, Part I: Historical Review and Own Cadaver Studies","authors":"J. Warnke1, M. Tschabitscher2, A. Nobles3","doi":"10.1055/s-2001-16006","DOIUrl":"https://doi.org/10.1055/s-2001-16006","url":null,"abstract":"","PeriodicalId":49808,"journal":{"name":"Minimally Invasive Neurosurgery","volume":"92 1","pages":"61 - 64"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80478174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Today, endoscopic third ventriculostomy is an established operative modality in occlusive hydrocephalus. The elemental step in third ventriculostomy is the perforation of the floor of the third ventricle. Especially with a thickened third ventricular floor, anatomical orientation can be disturbed and perforation of third ventricular floor technically difficult. The combination of a neuronavigation system with an endoscope provides interactive image-guided neuroendoscopy. Exact planning of the approach is thus possible and the ideal trajectory to the target area can be determined. We have combined interactive neuronavigation and intraoperative fluoroscopy for incorporating real-time feedback to optimize endoscopy in patients with a thickened third ventricular floor selected for third ventriculostomy.
{"title":"Operative Management of Third Ventriculostomy in Cases of Thickened, Non-Translucent Third Ventricular Floor: Technical Note","authors":"T. Riegel, O. Alberti, D. Hellwig, H. Bertalanffy","doi":"10.1055/s-2001-16005","DOIUrl":"https://doi.org/10.1055/s-2001-16005","url":null,"abstract":"Today, endoscopic third ventriculostomy is an established operative modality in occlusive hydrocephalus. The elemental step in third ventriculostomy is the perforation of the floor of the third ventricle. Especially with a thickened third ventricular floor, anatomical orientation can be disturbed and perforation of third ventricular floor technically difficult. The combination of a neuronavigation system with an endoscope provides interactive image-guided neuroendoscopy. Exact planning of the approach is thus possible and the ideal trajectory to the target area can be determined. We have combined interactive neuronavigation and intraoperative fluoroscopy for incorporating real-time feedback to optimize endoscopy in patients with a thickened third ventricular floor selected for third ventriculostomy.","PeriodicalId":49808,"journal":{"name":"Minimally Invasive Neurosurgery","volume":"1 1","pages":"65 - 69"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89420767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Since the original description by Liliequist only a few microanatomical studies of the Liliequist membrane have been performed. These studies contain some discrepancies in the description, boundaries, and attachments of the membrane. Using a surgical microscope the authors examined the microsurgical anatomy of Liliequist's membrane and surrounding neurovascular structures in twenty adult brains injected with silicone rubber, with special emphasis given to the analysis of controversial details. This description is intended as an aid for neurosurgeons performing neuroendoscopic procedures.
{"title":"Microsurgical Anatomy of the Liliequist's Membrane and Surrounding Neurovascular Territories","authors":"F. Vinas, M. Panigrahi","doi":"10.1055/s-2001-15999","DOIUrl":"https://doi.org/10.1055/s-2001-15999","url":null,"abstract":"Since the original description by Liliequist only a few microanatomical studies of the Liliequist membrane have been performed. These studies contain some discrepancies in the description, boundaries, and attachments of the membrane. Using a surgical microscope the authors examined the microsurgical anatomy of Liliequist's membrane and surrounding neurovascular structures in twenty adult brains injected with silicone rubber, with special emphasis given to the analysis of controversial details. This description is intended as an aid for neurosurgeons performing neuroendoscopic procedures.","PeriodicalId":49808,"journal":{"name":"Minimally Invasive Neurosurgery","volume":"16 1","pages":"104 - 109"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73721473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Kamikawa1, A. Inui2, N. Kobayashi1, N. Tamaki3, T. Yamadori4
{"title":"Intraventricular Hemorrhage in Neonates: Endoscopic Findings and Treatment by the Use of our Newly Developed Yamadori-Type 8 Ventriculoscope","authors":"S. Kamikawa1, A. Inui2, N. Kobayashi1, N. Tamaki3, T. Yamadori4","doi":"10.1055/s-2001-16001","DOIUrl":"https://doi.org/10.1055/s-2001-16001","url":null,"abstract":"","PeriodicalId":49808,"journal":{"name":"Minimally Invasive Neurosurgery","volume":"23 1","pages":"74 - 78"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83560189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Duffner1, D. Freudenstein1, F. Hohenstein2, M. Skalej3, E. Grote1
{"title":"Quality Planning for Minimally Invasive Procedures in Neurosurgery","authors":"F. Duffner1, D. Freudenstein1, F. Hohenstein2, M. Skalej3, E. Grote1","doi":"10.1055/s-2001-16007","DOIUrl":"https://doi.org/10.1055/s-2001-16007","url":null,"abstract":"","PeriodicalId":49808,"journal":{"name":"Minimally Invasive Neurosurgery","volume":"53 1","pages":"95 - 98"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84232081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Gönül1, Y. Izci1, M. Safali2, A. Baysefer1, N. Seber1
{"title":"Multiple Sclerosis with Mass Effect: Case Report","authors":"E. Gönül1, Y. Izci1, M. Safali2, A. Baysefer1, N. Seber1","doi":"10.1055/s-2001-16004","DOIUrl":"https://doi.org/10.1055/s-2001-16004","url":null,"abstract":"","PeriodicalId":49808,"journal":{"name":"Minimally Invasive Neurosurgery","volume":"61 1","pages":"117 - 120"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74150359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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