"Plug" ósseo autógeno para orifícios de trepanação: nota técnica

Vialogo, Josué Guimarães Granha

doi:10.1590/s0004-282x1999000600025

Cited by 8 publications

(1 citation statement)

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“…O orifício de trépano foi feito à direita, imediatamente à frente da sutura coronal, a 2.5 cm da linha média (ponto de Kocher). O pó de osso foi recolhido para confecção de botão ósseo autólogo, que serve para ocluir o orifício de trépano e evitar fístula liquórica pós neuroendoscopia 1 . Após a penetração do neuroendoscópio dentro da cavidade ventricular, retiramos os obturadores do canal de trabalho e de drenagem, liberando-os para os procedimentos.…”

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Acesso endoscópico transepto-interforniceal para cistos colóides: relato de caso

Vialogo

2000

Arq. Neuro-Psiquiatr.

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RESUMO -A abordagem endoscópica de cistos colóides ainda é matéria controversa. As opções de tratamento são variadas: observação com exames seriados, tratamento da hidrocefalia, aspiração por estereotaxia, microcirurgia e endoscopia. O autor relata o caso de um paciente com cisto colóide do terceiro ventrículo, localizado em posição retroforaminal, no teto diencefálico, dissecando os dois fornices projetando-se supero-posteriormente em direção ao assoalho do ventrículo lateral, por dentro do cavum do septo pelúcido. A lesão foi alcançada com neuroendoscópio rígido, através de um orifício de trépano pré-coronal situado a 2,5 cm da linha média (ponto de Kocher). Seguindo por via transventricular, a lâmina direita do septo pelúcido foi aberta, posterior à veia septal. A lesão, muito endurecida, situada entre os dois fórnices, foi parcialmente ressecada através da via endoscópica transventricular transepto-interforniceal. Realizamos também septostomia e terceiro ventriculostomia endoscópicas neste paciente. Os diferentes tipos de procedimentos cirúrgicos das patologias situadas no terceiro ventrículo são discutidos com ênfase no papel da endoscopia.PALAVRAS-CHAVE: cisto colóide retroforaminal, abordagem endoscópica transepto-interforniceal. Endoscopic transepto-interforniceal approach to colloid cysts: case reportABSTRACT -The endoscopic treatment of colloid cysts of third ventricle is still controversial. Management of the patient can include observation and serial CT or MRI imaging only, ventriculo peritoneal shunt only, estereotactic aspiration, microsurgery and endoscopy. The author reports the case of a patient with colloid cyst of third ventricle located in a retroforaminal position, in the diencefalic roof, dissecting the raphe fornix, expanding supero-posteriorly, inside the cavum of the septum pellucidum, protruding on the floor of lateral ventricles. The cyst was approached with a rigid neuroendoscope, through a pre-coronal burr hole, 2.5 cm lateral to the midline (Kocher´s point). Following a transventricular route, the right leaf of the septum pellucidum was endoscopically opened with bipolar, posterior to the septal vein. A yellowish hard lesion was found and partially resected with biopsy forceps, between the two fornices, which were split apart by the uncommon expansion and location of the lesion, allowing a new endoscopic transventricular transepto-interforniceal approach. We also performed endoscopic septostomy and third ventriculostomy. The microsurgical approaches compared with endoscopic approaches, and the possibility of endoscopic alternative routes suitable for selected cases with superior expansion towards the fornix and septum pellucidum is discussed.KEY WORDS: retroforaminal colloid cyst, endoscopic transepto-interforniceal approach.O tratamento endoscópico de cistos colóides do terceiro ventrículo é matéria de controvérsia em neurocirurgia. A microcirurgia é considerada a técnica padrão para estes casos, porém a ressecção endoscópica com várias séries referindo ressecção total, quase compa...

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Section: Casounclassified

Acesso endoscópico transepto-interforniceal para cistos colóides: relato de caso

Vialogo

2000

Arq. Neuro-Psiquiatr.

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Application of osteoinductive calcium phosphate ceramics in children’s endoscopic neurosurgery: report of five cases

Wei

Qian

Liu

et al. 2018

Regenerative Biomaterials

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This work aimed at investigating the possibility and effectiveness of osteoinductive calcium phosphate (CaP) ceramics to close the drilled skull holes and prevent the postoperative cerebrospinal fluid (CSF) leaking in children’s endoscopic neurosurgery. Five children patients (four boys and one girl, 3- to 8-years old) underwent the surgery, in which the endoscopic third ventriculostomy (ETV) was operated in four cases of hydrocephalus, and biopsy and ETV were both performed in one case of pineal tumor. The drilled skull holes were filled with the commercial osteoinductive CaP ceramics. The patients were followed up by CT scan at 1, 7 days, 3 and 6 months postoperatively. All the five cases were successful, and the holes were closed well after filled with the ceramics. The follow-up survey showed that no CSF leaking or rejection reaction was found. The CT scan indicated that the drilled holes began healing at 7 days postoperatively, and a relatively complete healing happened at 6 months postoperatively. The excellent ability of the CaP ceramics to induce bone regeneration was also confirmed by repairing the skull defects in a monkey model. The results of μ-CT and histological analysis showed that a bony structure with irregular array occurred at the defect area, and the newly formed bone volume density reached 65.7%. In conclusion, the osteoinductive CaP ceramics could be an ideal material to treat the drilled skull holes in children’s endoscopic neurosurgery and prevent CSF leaking afterwards. However, further investigation with more cases and longer follow-up was required to evaluate the clinical effect.

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Permanence of Diced Cartilage, Bone Dust and Diced Cartilage/Bone Dust Mixture in Experimental Design in Twelve Weeks

Islamoglu¹,

Dikici²,

Özgentaş³

2006

Journal of Craniofacial Surgery

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Bone dust and diced cartilage are used for contour restoration because their minimal donor site morbidity. The purpose of this study is to investigate permanence of bone dust, diced cartilage and bone dust/diced cartilage mixture in rabbits over 12 weeks. New Zealand white rabbits were used for this study. There were three groups in the study: Group I: 1 mL bone dust. Group II: 1 mL diced cartilage. Group III: 0.5 mL bone dust + 0.5 mL diced cartilage mixture. They were placed into subcutaneous tissue of rabbits and removed 12 weeks later. The mean volumes of groups were 0.23 +/- 0.08 mL in group I, 0.60 +/- 0.12 mL in group II and 0.36 +/- 0.10 mL in group III. The differences between groups were found statistically significant. In conclusion, diced cartilage was found more reliable than bone dust aspect of preserving its volume for a long period in this study.

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"Plug" ósseo autógeno para orifícios de trepanação: nota técnica

Cited by 8 publications

References 1 publication

Acesso endoscópico transepto-interforniceal para cistos colóides: relato de caso

Acesso endoscópico transepto-interforniceal para cistos colóides: relato de caso

Application of osteoinductive calcium phosphate ceramics in children’s endoscopic neurosurgery: report of five cases

Permanence of Diced Cartilage, Bone Dust and Diced Cartilage/Bone Dust Mixture in Experimental Design in Twelve Weeks

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