Multimodal Use of Contact Endoscopy in Neurosurgery: Case Series with Technical Note and Literature Review.

Autor: Carbone F; Department of Neurosurgery - Karlsruher Neurozentrum, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany; Division of Neurosurgery, University of Foggia, Foggia, Italy., Colamaria A; Division of Neurosurgery, Policlinico 'Riuniti', Foggia, Italy., Corvino S; Department of Neuroscience and Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, University Federico II, Naples, Italy., Sacco M; Division of Neurosurgery, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy., Iaconetta G; Division of Neurosurgery, School of Medicine 'Scuola Medica Salernitana', University of Salerno, Fisciano, Italy., Corrivetti F; Division of Neurosurgery, Department of Surgical Specialties, San Filippo Neri Hospital/ASL 1, Roma, Italy., Di Maria D; Unit of Otorhinolaryngology, 'San Pio' Hospital, Benevento, Italy., Catapano G; Division of Neurosurgery, 'Ospedale del Mare' Hospital, Naples, Italy., Fochi NP; Division of Neurosurgery, University of Foggia, Foggia, Italy., Leone A; Department of Neurosurgery - Karlsruher Neurozentrum, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany; Faculty of Human Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany. Electronic address: augustoleone96@gmail.com., Spetzger U; Department of Neurosurgery - Karlsruher Neurozentrum, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany., de Notaris M; Department of Neuroscience, Neurosurgery Operative Unit, 'San Pio' Hospital, Benevento, Italy.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2024 Feb; Vol. 182, pp. e657-e665. Date of Electronic Publication: 2023 Dec 08.
DOI: 10.1016/j.wneu.2023.12.014
Abstrakt: Background: Originally adopted for the cytological screening of cervical and uterine cancer, contact endoscopy (CE) is now widely used in several fields of oncological surgery. The CE method, with magnification power up to 150x, was designed to enhance visualization and identify microscopic changes indicative of precancerous and cancerous lesions at early stages. In this pilot study, we evaluated the multimodal applications of CE during different endoscopic intracranial neurosurgical procedures.
Methods: Twenty patients with skull base lesions underwent surgery using different minimally invasive endoscopic approaches (endonasal, transorbital, and supraorbital). CE was used to distinguish the pathology from the surrounding healthy tissue by positioning the endoscope either in proximity or directly onto the target tissue. Special attention was given to the visualization of the margins of the lesion to differentiate compression/displacement from infiltration of the normal surrounding tissue.
Results: With its unprecedented range of magnification, CE could clearly identify the microvascular pattern and cytological architecture of a tissue not detectable by simple white light endoscopy, with no reported damage due to heat transmission or iatrogenic injuries. All the lesions diagnosed as "presumed neoplastic tissue" by CE were confirmed by histopathology. The most promising results were observed in surgeries for meningioma and pituitary adenoma, as these lesions exhibit distinctive microvascular networks.
Conclusions: CE represents a new and effective technique for the in vivo identification of pathological microvascular and tissue features, allowing preservation of normal tissue during different endoscopic approaches. The use of CE could improve diagnostic accuracy and assist in intraoperative decision-making, becoming a key tool in various applications in neurosurgical field.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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