Pub Date : 2024-01-01DOI: 10.3171/2023.10.focvid23135
Alejandra Rodas, Edoardo Porto, J. R. Revuelta Barbero, Jackson Vuncannon, Youssef M. Zohdy, Biren Khimji Patel, Gustavo Pradilla, C. Solares
Skull base malignancies arising from the parotid gland, skin, or external auditory canal (EAC) can potentially involve the temporal bone. Management of these invasive tumors represents a true challenge considering the critical neurovascular relationships. Exoscope-assisted temporal bone resection (TBR) plays a crucial role in addressing such malignancies. The extent of disease is evaluated using the Pittsburgh staging system, which then guides the boundaries of resection. Lateral TBR (LTBR) relies on removal of the EAC and lateral ossicles and is generally appropriate for stage T1 and T2 tumors. Total TBR (TTBR) is reserved for high-grade tumors involving the petrous apex. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23135
{"title":"Exoscope-assisted temporal bone resection: operative videos of the lateral and total techniques","authors":"Alejandra Rodas, Edoardo Porto, J. R. Revuelta Barbero, Jackson Vuncannon, Youssef M. Zohdy, Biren Khimji Patel, Gustavo Pradilla, C. Solares","doi":"10.3171/2023.10.focvid23135","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23135","url":null,"abstract":"Skull base malignancies arising from the parotid gland, skin, or external auditory canal (EAC) can potentially involve the temporal bone. Management of these invasive tumors represents a true challenge considering the critical neurovascular relationships. Exoscope-assisted temporal bone resection (TBR) plays a crucial role in addressing such malignancies. The extent of disease is evaluated using the Pittsburgh staging system, which then guides the boundaries of resection. Lateral TBR (LTBR) relies on removal of the EAC and lateral ossicles and is generally appropriate for stage T1 and T2 tumors. Total TBR (TTBR) is reserved for high-grade tumors involving the petrous apex. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23135","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"141 51","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139128345","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}
Pub Date : 2024-01-01DOI: 10.3171/2023.10.focvid23140
Arpan A. Patel, Erion Júnior de Andrade, Shaarada R Srivatsa, P. Recinos
The authors present an operative video of a supraorbital craniotomy for resection of a suprasellar, supradiaphragmatic craniopharyngioma. The patient is a 62-year-old female who presented with 3 months of blurry vision secondary to a 2.5-cm suprasellar mass causing compression on the optic nerve. Supraorbital craniotomy was selected due to the supradiaphragmatic location of the tumor and the subsequent disadvantages, including CSF leakage, of other approaches such as the endoscopic endonasal approach. The operative video emphasizes optimizing operating room (OR) setup to improve surgeon ergonomics and comfort. The patient underwent an uncomplicated gross-total resection with subsequent discharge home the day after surgery. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23140
{"title":"Exoscopic supraorbital approach for a suprasellar craniopharyngioma","authors":"Arpan A. Patel, Erion Júnior de Andrade, Shaarada R Srivatsa, P. Recinos","doi":"10.3171/2023.10.focvid23140","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23140","url":null,"abstract":"The authors present an operative video of a supraorbital craniotomy for resection of a suprasellar, supradiaphragmatic craniopharyngioma. The patient is a 62-year-old female who presented with 3 months of blurry vision secondary to a 2.5-cm suprasellar mass causing compression on the optic nerve. Supraorbital craniotomy was selected due to the supradiaphragmatic location of the tumor and the subsequent disadvantages, including CSF leakage, of other approaches such as the endoscopic endonasal approach. The operative video emphasizes optimizing operating room (OR) setup to improve surgeon ergonomics and comfort. The patient underwent an uncomplicated gross-total resection with subsequent discharge home the day after surgery. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23140","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"2 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139129005","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}
Pub Date : 2024-01-01DOI: 10.3171/2023.10.focvid23149
J. Herta, Karl Rössler, C. Dorfer
For microvascular decompression surgery, adequate visualization of the trigeminal nerve root is essential. Several visualization techniques with operating microscopes, endoscopes, a combination of both, and exoscopes have been described. In this video, the authors use a 4K 3D exoscope (ORBEYE) as it offers superb optical image quality with a high degree of magnification and illumination in the cerebellopontine angle. Other advantages are surgeon ergonomics, a very good depth of field for the entire operating team, and potentially evolving visualization technologies like narrow-band imaging—essential points for microvascular decompression surgery where the aim is to create the best possible visibility in a narrow corridor. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23149
对于微血管减压手术来说，充分观察三叉神经根是至关重要的。已经介绍了几种使用手术显微镜、内窥镜、两者结合以及外窥镜的可视化技术。在本视频中，作者使用的是 4K 3D 外窥镜（ORBEYE），因为它具有极佳的光学图像质量、高放大率和小脑角照明。其他优势还包括外科医生的人体工程学设计、为整个手术团队提供了非常好的景深，以及潜在的可视化技术（如窄带成像）--这对于微血管减压手术至关重要，因为手术的目的是在狭窄的走廊中创造尽可能好的可视性。视频请点击： https://stream.cadmore.media/r10.3171/2023.10.FOCVID23149
{"title":"Use of a 3D exoscope in microvascular decompression of the trigeminal nerve root","authors":"J. Herta, Karl Rössler, C. Dorfer","doi":"10.3171/2023.10.focvid23149","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23149","url":null,"abstract":"For microvascular decompression surgery, adequate visualization of the trigeminal nerve root is essential. Several visualization techniques with operating microscopes, endoscopes, a combination of both, and exoscopes have been described. In this video, the authors use a 4K 3D exoscope (ORBEYE) as it offers superb optical image quality with a high degree of magnification and illumination in the cerebellopontine angle. Other advantages are surgeon ergonomics, a very good depth of field for the entire operating team, and potentially evolving visualization technologies like narrow-band imaging—essential points for microvascular decompression surgery where the aim is to create the best possible visibility in a narrow corridor. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23149","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"49 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139127064","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}
Pub Date : 2024-01-01DOI: 10.3171/2023.10.focvid23150
J. Khalifeh, Ali Karim Ahmed, Wataru Ishida, J. Materi, Anita L Kalluri, D. Lubelski, T. Witham, Nicholas Theodore, Debraj Mukherjee, Judy Huang
The extracorporeal telescope (exoscope) presents a novel digital camera system as a versatile alternative to traditional optical microscopy for microsurgery and minimally invasive neurosurgical operations. Recent innovations in exoscope technology offer 4K-definition multiscreen outputs, pneumatic robot arms, 3-dimensional depth perception, and greater illumination, focus, and magnification powers for enhanced intraoperative visualization. The authors present their initial institutional experience using a robotic arm–enabled 4K 3D exoscope in a variety of cranial and spinal neurosurgical operations, namely Chiari decompression, microvascular decompression for trigeminal neuralgia, anterior cervical discectomy, and lumbar decompressions. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23150
体外显微镜（exoscope）是一种新型数字摄像系统，是显微外科和微创神经外科手术中传统光学显微镜的多功能替代品。外窥镜技术的最新创新提供了 4K 清晰度多屏输出、气动机械臂、三维深度感知以及更强的照明、聚焦和放大能力，从而增强了术中可视化。作者介绍了他们在各种颅脑和脊柱神经外科手术中使用机器人手臂支持的 4K 3D 外窥镜的初步机构经验，这些手术包括 Chiari 减压术、三叉神经痛微血管减压术、前路颈椎椎间盘切除术和腰椎减压术。视频请点击：https://stream.cadmore.media/r10.3171/2023.10.FOCVID23150
{"title":"Initial institutional experience using a robotic arm–enabled 4K 3D exoscope in neurosurgical operations","authors":"J. Khalifeh, Ali Karim Ahmed, Wataru Ishida, J. Materi, Anita L Kalluri, D. Lubelski, T. Witham, Nicholas Theodore, Debraj Mukherjee, Judy Huang","doi":"10.3171/2023.10.focvid23150","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23150","url":null,"abstract":"The extracorporeal telescope (exoscope) presents a novel digital camera system as a versatile alternative to traditional optical microscopy for microsurgery and minimally invasive neurosurgical operations. Recent innovations in exoscope technology offer 4K-definition multiscreen outputs, pneumatic robot arms, 3-dimensional depth perception, and greater illumination, focus, and magnification powers for enhanced intraoperative visualization. The authors present their initial institutional experience using a robotic arm–enabled 4K 3D exoscope in a variety of cranial and spinal neurosurgical operations, namely Chiari decompression, microvascular decompression for trigeminal neuralgia, anterior cervical discectomy, and lumbar decompressions. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23150","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"55 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139127704","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}
Pub Date : 2024-01-01DOI: 10.3171/2023.10.focvid23158
Sanjeev Sreenivasan, Danielle Golub, Karen Black, Michael Schulder
An exoscope strengthens the armamentarium of a neurosurgeon by improving visualization and surgeon ergonomics, reducing surgeon discomfort, and improving coordination among the surgical team. A 23-year-old male patient developed focal seizures and weakness affecting his right arm that was attributable to a recurrent left frontal lesion. Despite two craniotomies at an 8-year interval, chemotherapy, and radiation, the tumor continued to progress. In this video, the authors demonstrate resection of a recurrent left frontal pilocytic astrocytoma with the assistance of an exoscope, neuronavigation, and neuromonitoring. The exoscope can enhance surgical resectability while smoothening the surgical workflow. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23158
{"title":"Exoscope-assisted resection of a recurrent left frontal pilocytic astrocytoma","authors":"Sanjeev Sreenivasan, Danielle Golub, Karen Black, Michael Schulder","doi":"10.3171/2023.10.focvid23158","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23158","url":null,"abstract":"An exoscope strengthens the armamentarium of a neurosurgeon by improving visualization and surgeon ergonomics, reducing surgeon discomfort, and improving coordination among the surgical team. A 23-year-old male patient developed focal seizures and weakness affecting his right arm that was attributable to a recurrent left frontal lesion. Despite two craniotomies at an 8-year interval, chemotherapy, and radiation, the tumor continued to progress. In this video, the authors demonstrate resection of a recurrent left frontal pilocytic astrocytoma with the assistance of an exoscope, neuronavigation, and neuromonitoring. The exoscope can enhance surgical resectability while smoothening the surgical workflow. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23158","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"53 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139127727","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}
Pub Date : 2024-01-01DOI: 10.3171/2023.10.focvid23105
Jia Xu Lim, W. Seow, Zhi Min Ng, Sharon Y. Y. Low
Selective dorsal rhizotomy (SDR) is an established neurosurgical technique for children with spastic diplegia secondary to cerebral palsy. Meticulous intraoperative testing of individual nerve roots with electromyography in tandem with the on-site neurorehabilitation team is recommended for good clinical outcomes. The standard approach requires the neurosurgeons to spend extended time under the traditional operating microscope. In this video, the authors describe the use of a 3D exoscope system for SDR. Overall, the 3D exoscope improves ergonomics and reduces musculoskeletal fatigue for the operating neurosurgeons. Furthermore, it provides excellent visualization of important structures, allowing safe and efficient completion of the procedure. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23105
{"title":"Selective dorsal rhizotomy using a 3D high definition exoscope","authors":"Jia Xu Lim, W. Seow, Zhi Min Ng, Sharon Y. Y. Low","doi":"10.3171/2023.10.focvid23105","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23105","url":null,"abstract":"Selective dorsal rhizotomy (SDR) is an established neurosurgical technique for children with spastic diplegia secondary to cerebral palsy. Meticulous intraoperative testing of individual nerve roots with electromyography in tandem with the on-site neurorehabilitation team is recommended for good clinical outcomes. The standard approach requires the neurosurgeons to spend extended time under the traditional operating microscope. In this video, the authors describe the use of a 3D exoscope system for SDR. Overall, the 3D exoscope improves ergonomics and reduces musculoskeletal fatigue for the operating neurosurgeons. Furthermore, it provides excellent visualization of important structures, allowing safe and efficient completion of the procedure. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23105","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139127743","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}
Pub Date : 2024-01-01DOI: 10.3171/2023.10.focvid23114
S. Tola, Federico Capelli, Alessandro Della Puppa
The advantages of the surgical view provided by the exoscope have been described before, although reports of its application to brain arteriovenous malformation (AVM) surgery are lacking. The ampler field of view and magnification up to ×24 allow for enhanced visualization during microsurgical procedures. Furthermore, the live visualization provided by indocyanine green video angiography (ICG-VA) helps emphasize the hemodynamics of AVMs, even allowing the detection of possible residual vein arterialization as an indirect expression of nidal remnants. With this illustrative video showing the resection of a hemorrhagic right frontoinsular Spetzler-Martin grade III AVM, the authors describe the technical implications of exoscope brain AVM surgery using the Olympus ORBEYE 4K-3D, with a final focus on ICG-VA as an asset. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23114
{"title":"Can exoscope improve brain AVMs surgery?","authors":"S. Tola, Federico Capelli, Alessandro Della Puppa","doi":"10.3171/2023.10.focvid23114","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23114","url":null,"abstract":"The advantages of the surgical view provided by the exoscope have been described before, although reports of its application to brain arteriovenous malformation (AVM) surgery are lacking. The ampler field of view and magnification up to ×24 allow for enhanced visualization during microsurgical procedures. Furthermore, the live visualization provided by indocyanine green video angiography (ICG-VA) helps emphasize the hemodynamics of AVMs, even allowing the detection of possible residual vein arterialization as an indirect expression of nidal remnants. With this illustrative video showing the resection of a hemorrhagic right frontoinsular Spetzler-Martin grade III AVM, the authors describe the technical implications of exoscope brain AVM surgery using the Olympus ORBEYE 4K-3D, with a final focus on ICG-VA as an asset. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23114","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"58 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139128161","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}
Pub Date : 2024-01-01DOI: 10.3171/2023.10.focvid23122
Hiroki Toda, Hirokuni Hashikata, Ryota Ishibashi
The 4K 3D exoscope system is becoming increasingly used in neurosurgery. Its 3D ultra-high-definition image is valuable in identifying and dissecting the delicate neural and vascular structures during microvascular decompression. In this video, the authors describe several nuances and details to perform the exoscopic microvascular decompression, including the exoscope layout and the modified supine position. Several illustrative case presentations highlight the benefits of exoscopic surgery. The authors’ exoscopic microvascular decompression series of 159 patients showed noninferior surgical outcomes compared to the operative microscope with no significant increase in surgical risk. In conclusion, an exoscope can be a practical alternative to performing microvascular decompression. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23122
4K 3D 外窥镜系统在神经外科的应用越来越广泛。其三维超高清图像对于在微血管减压术中识别和解剖精细的神经和血管结构非常有价值。在这段视频中，作者介绍了进行外镜下微血管减压术的几个细微差别和细节，包括外镜布局和改良仰卧位。几例例证突出了外镜手术的优势。作者在外镜下对 159 名患者进行了微血管减压，结果显示手术效果并不逊于手术显微镜，手术风险也没有显著增加。总之，外窥镜是进行微血管减压术的一种实用替代方法。视频请点击此处： https://stream.cadmore.media/r10.3171/2023.10.FOCVID23122
{"title":"Exoscopic microvascular decompression for hemifacial spasm and trigeminal neuralgia","authors":"Hiroki Toda, Hirokuni Hashikata, Ryota Ishibashi","doi":"10.3171/2023.10.focvid23122","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23122","url":null,"abstract":"The 4K 3D exoscope system is becoming increasingly used in neurosurgery. Its 3D ultra-high-definition image is valuable in identifying and dissecting the delicate neural and vascular structures during microvascular decompression. In this video, the authors describe several nuances and details to perform the exoscopic microvascular decompression, including the exoscope layout and the modified supine position. Several illustrative case presentations highlight the benefits of exoscopic surgery. The authors’ exoscopic microvascular decompression series of 159 patients showed noninferior surgical outcomes compared to the operative microscope with no significant increase in surgical risk. In conclusion, an exoscope can be a practical alternative to performing microvascular decompression. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23122","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"56 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139125478","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}
Pub Date : 2024-01-01DOI: 10.3171/2023.10.focvid23161
Grant Arzumanov, Seung W. Jeong, Bhavika Gupta, Rocco Dabecco, Jose Sandoval, Matthew J. Shepard, Jody Leonardo, Alexander Yu
The occipital approach for pineal tumors was first described by James Poppen in 1966. Since then, it has been widely used for accessing deep-seated tumors as it offers a wider surgical view than the supracerebellar transtentorial approach. This video demonstrates the technical nuances of the occipital transtentorial approach and the exoscopic dissection of a pineal gland tumor in a 66-year-old male. Use of the exoscope over the microscope provides certain ergonomic advantages and improves surgical workflow, as demonstrated here. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23161
{"title":"Occipital-interhemispheric transtentorial pineal mass resection","authors":"Grant Arzumanov, Seung W. Jeong, Bhavika Gupta, Rocco Dabecco, Jose Sandoval, Matthew J. Shepard, Jody Leonardo, Alexander Yu","doi":"10.3171/2023.10.focvid23161","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23161","url":null,"abstract":"The occipital approach for pineal tumors was first described by James Poppen in 1966. Since then, it has been widely used for accessing deep-seated tumors as it offers a wider surgical view than the supracerebellar transtentorial approach. This video demonstrates the technical nuances of the occipital transtentorial approach and the exoscopic dissection of a pineal gland tumor in a 66-year-old male. Use of the exoscope over the microscope provides certain ergonomic advantages and improves surgical workflow, as demonstrated here. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23161","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"88 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139125109","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}
Pub Date : 2024-01-01DOI: 10.3171/2023.10.focvid23164
Alejandro Carrasquilla, Artur Zgurov, Mira Salih, Chi Le, Stavros Matsoukas, Rui Feng, Alexander J Schupper, Constantinos G. Hadjipanayis
This video demonstrates use of the Synaptive 3D exoscope to enhance complex meningioma resection. The patient was a 58-year-old female who presented with new-onset seizures. Workup revealed a parasagittal meningioma over the bilateral cortices. She was started on 750 mg of Keppra twice daily and tapered dexamethasone and discharged. MR venography demonstrated segmental occlusion of the superior sagittal sinus. She then underwent a diagnostic angiogram and tumor Onyx embolization of the bilateral middle meningeal artery feeders. She then underwent a craniotomy for meningioma resection using 3D exoscope guidance. She awoke with a stable examination in the intensive care unit and worked with physical therapy on postoperative day 1. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23164
这段视频演示了使用 Synaptive 3D 外窥镜加强复杂脑膜瘤切除术的过程。患者是一名 58 岁的女性，因新发癫痫而就诊。检查发现双侧大脑皮层有一个矢状旁脑膜瘤。患者开始服用750毫克的开普拉（Keppra），每天两次，并逐渐减量地塞米松，随后出院。磁共振静脉造影显示上矢状窦有节段性闭塞。随后，她接受了诊断性血管造影，并对双侧脑膜中动脉供血动脉进行了肿瘤Onyx栓塞治疗。然后，她在三维外窥镜引导下接受了开颅脑膜瘤切除术。她在重症监护室醒来时检查结果稳定，术后第 1 天接受了物理治疗。视频请点击： https://stream.cadmore.media/r10.3171/2023.10.FOCVID23164
{"title":"Exoscopic resection of a parasagittal atypical meningioma","authors":"Alejandro Carrasquilla, Artur Zgurov, Mira Salih, Chi Le, Stavros Matsoukas, Rui Feng, Alexander J Schupper, Constantinos G. Hadjipanayis","doi":"10.3171/2023.10.focvid23164","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23164","url":null,"abstract":"This video demonstrates use of the Synaptive 3D exoscope to enhance complex meningioma resection. The patient was a 58-year-old female who presented with new-onset seizures. Workup revealed a parasagittal meningioma over the bilateral cortices. She was started on 750 mg of Keppra twice daily and tapered dexamethasone and discharged. MR venography demonstrated segmental occlusion of the superior sagittal sinus. She then underwent a diagnostic angiogram and tumor Onyx embolization of the bilateral middle meningeal artery feeders. She then underwent a craniotomy for meningioma resection using 3D exoscope guidance. She awoke with a stable examination in the intensive care unit and worked with physical therapy on postoperative day 1. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23164","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139129490","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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