Neuroendoscopic Intraventricular Biopsy in Children with Small Ventricles Using Frameless VarioGuide System
| Autor: | Francisco Villarejo, Marcelo Budke, Josue M Avecillas-Chasin |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Cerebral Ventricle Neoplasms Endoscope Adolescent Biopsy Developmental Disabilities Hamartoma Vision Disorders Cerebral Ventricles 03 medical and health sciences 0302 clinical medicine medicine Humans Child Growth Disorders Retrospective Studies Third ventricle medicine.diagnostic_test business.industry Neuroendoscopes Endoscopic third ventriculostomy medicine.disease Craniopharyngioma Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Child Preschool Cerebral ventricle Neuroendoscopy Female Neurology (clinical) Radiology Germinoma Hypothalamic Neoplasms business 030217 neurology & neurosurgery |
| Zdroj: | World neurosurgery. 87 |
| ISSN: | 1878-8769 |
| Popis: | Endoscopic biopsy for intraventricular tumors in pediatric patients with small ventricles is a challenging procedure because of the risk of morbidity during the intraventricular approach. We describe the use of the VarioGuide system for intraventricular endoscopic biopsy in 9 consecutive pediatric patients with intraventricular lesions and small ventricular size. All patients had lesions in the anterior part of the third ventricle with a median frontal and occipital horn ratio of 0.33. Patients presented with growth failure ( n = 4), visual disturbances ( n = 4), and seizures ( n = 1). The VarioGuide system consists of an ergonomic arm with 3 joints for gross adjustment. The 3 rotational joints on the distal side of the system are adjusted according to the angles of the planned trajectory. The endoscope is adjusted to the distal side of the VarioGuide and inserted through the ring, previously set for the diameter of the endoscope and for the planned trajectory. The accuracy of the trajectory and correct ventricular cannulation are confirmed under endoscopic guidance. The biopsy is carried out according to the standard technique. In all cases, the biopsy sample provided the definitive diagnosis. Diagnoses included germinomas in 4 patients, hamartoma in 1 patient, hypothalamic astrocytoma in 2 patients, and craniopharyngioma in 2 patients. The use of the VarioGuide system for intraventricular endoscopic biopsy is highly recommended for pediatric patients with small ventricle size. This technique may help minimize the risk of unnecessary brain damage during the entrance to small ventricles. |
| Databáze: | OpenAIRE |
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