Endoscopy-assisted burr hole evacuation of subdural empyema

Kirollos, R. W.; Tyagi, Ajai K; Boles, D M

doi:10.1080/02688699647339

Cited by 11 publications

(7 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Discussionmentioning

confidence: 99%

“…Successful evacuation of subdural haematomas, pus as well as hygromas have been achieved with the use of endoscopic [ 21 , 47 , 48 ]. The endoscope assists in the assessment of the subdural space to ensure satisfactory clot evacuation as well as haemostasis, and to incise abnormal membranes as well as trabecula in instances of loculated CSDHs [ 21 , 28 , 47 , 48 ]. Furthermore, during the procedure, the surgeon is able to irrigate the hematoma cavity, insert a drainage tube toward the frontal convexity to evacuate subdural air, avoid cortical laceration that often happen as result of blind manipulation, coagulate the source of bleeding as well as separate the inner membrane carefully to aid in brain expansion [ 22 – 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, about 2.5–33% of recurrence rates are associated with the treatment modalities above [ 6 , 19 , 20 ]. Endoscope-assisted evacuation of CSDHs is an accepted technique, though not generally used [ 21 – 28 ]. It is an amalgamation of burr-hole evacuation of CSDH as well as inspection of the subdural space with an endoscope [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Hematoma cavity separation and neomembrane thickness are potential triggers of recurrence of chronic subdural hematoma

et al. 2022

View full text Add to dashboard Cite

Background Chronic subdural hematoma (CSDH) is the anomalous and encapsulated accumulation of fluid of complex origin consisting of old blood, mostly or totally liquified and cerebrospinal fluid (CSF) in the subdural space usually after a head injury in the elderly. Almost all the research on surgical techniques and endoscopic assisted evacuation of CSDH focused on the just the evacuation and not abnormal anatomical structures that causes recurrences. Objectives We investigated abnormal anatomical structures that triggers recurrence of CSDH during craniotomy as well as burr-hole craniostomy with endoscopic assistance. Materials and methods We retrospectively analyzed all patients with CSDH who underwent craniostomy and burr-hole craniotomy with endoscopic assisted evacuation of hematoma between April 2017 and November 2020 at our institution. Clinical data obtained was categorized into patient-related, radiology as well as surgery and endoscopic evaluations. Results A total of 143 patients (109 men and 34 women) aged 43–94 years (mean age, 68.35 years) with CSDH were included in this study. We observed a recurrence rate of 4.9% (7/143). Recurrences occurred between 2 and 6 months after the operation in patients with recurrences. Our data revealed that, age, hypertension, history of injury, diabetes, antiplatelet or anticoagulant use were not associated with hematoma recurrence. Nevertheless, all the patients with recurrence of hematoma were males. Interestingly, our univariate and multivariate analyses found neomembrane thickness and hematoma cavity separation as independent risk factors (OR,45.822; 95% CI,2.666-787.711; p = 0.008) for the recurrence of CSDH (p < 0.05). Also, we observed thickened membranes connecting/separating the dura and the thickened arachnoid/pia matters in all the 7 patients with hematoma recurrence. Conclusions The treatment of patients with CSDH ought to include the identification and resection of abnormal thickened membranes connecting/separating the dura and the thickened arachnoid/pia matters to avoid recurrence. Comparatively, endoscopy showed hematoma cavity separation or neomembrane thickness just as seen during craniotomy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hematoma cavity separation and neomembrane thickness are potential triggers of recurrence of chronic subdural hematoma

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Endoscope-assisted burr hole evacuation of subdural collections has previously been performed in the settings of chronic and subacute SDH, 8,21,23 subdural hygroma, 22 and subdural empyemas. 15 Mobbs and Khong 23 and Codd et al 4 demonstrated a similar 2-burr-hole approach to treat these subdural collections. However, it is important to distinguish an acute SDH from its chronic liquefied counter-parts.…”

Section: Acute Subdural Hematomasmentioning

confidence: 99%

Smartphone-assisted minimally invasive neurosurgery

Mandel

Petito

Tutihashi

et al. 2018

Journal of Neurosurgery

View full text Add to dashboard Cite

OBJECTIVE Advances in video and fiber optics since the 1990s have led to the development of several commercially available high-definition neuroendoscopes. This technological improvement, however, has been surpassed by the smartphone revolution. With the increasing integration of smartphone technology into medical care, the introduction of these high-quality computerized communication devices with built-in digital cameras offers new possibilities in neuroendoscopy. The aim of this study was to investigate the usefulness of smartphone-endoscope integration in performing different types of minimally invasive neurosurgery. METHODS The authors present a new surgical tool that integrates a smartphone with an endoscope by use of a specially designed adapter, thus eliminating the need for the video system customarily used for endoscopy. The authors used this novel combined system to perform minimally invasive surgery on patients with various neuropathological disorders, including cavernomas, cerebral aneurysms, hydrocephalus, subdural hematomas, contusional hematomas, and spontaneous intracerebral hematomas. RESULTS The new endoscopic system featuring smartphone-endoscope integration was used by the authors in the minimally invasive surgical treatment of 42 patients. All procedures were successfully performed, and no complications related to the use of the new method were observed. The quality of the images obtained with the smartphone was high enough to provide adequate information to the neurosurgeons, as smartphone cameras can record images in high definition or 4K resolution. Moreover, because the smartphone screen moves along with the endoscope, surgical mobility was enhanced with the use of this method, facilitating more intuitive use. In fact, this increased mobility was identified as the greatest benefit of the use of the smartphone-endoscope system compared with the use of the neuroendoscope with the standard video set. CONCLUSIONS Minimally invasive approaches are the new frontier in neurosurgery, and technological innovation and integration are crucial to ongoing progress in the application of these techniques. The use of smartphones with endoscopes is a safe and efficient new method of performing endoscope-assisted neurosurgery that may increase surgeon mobility and reduce equipment costs.

show abstract

“…3 In recent studies, it is noteworthy that the use of endoscopy has become widespread in the surgery of ASDH, 2,4-9 CSDH [10][11][12][13][14] and subdural collections such as subdural empyema. 15 There were many cases of subdural hematoma as performed with rigid endoscopes, 2,[4][5][6][7][8][9][10][11][12] and the authors commonly prefer the center or the thickest site of the hematoma as the entrance point. However, because of the inflexible nature of rigid endoscopes, the optimal location of the craniotomy may not be the center or thickest part of the hematoma in order to evaluate the surgical area in an extensive range.…”

mentioning

confidence: 99%

Subdural Hematoma Evacuation via Rigid Endoscopy System: A Cadaveric Study

Yakar

Egemen

Dere

et al. 2020

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

The utilization of endoscope-assisted surgery is becoming a more common modality for the surgical treatment of subdural collections. Considering the inflexible construction of the rigid endoscope, it's not clear where to perform the optimal craniotomy. Twenty four craniotomies (3 cm diameter) were performed in 8 hemicrania. The craniotomies were placed 1 cm front and behind the coronal suture and to the point where the parietal bone was the most convex. The craniotomies in the anterior (C1) and posterior (C2) of the coronal suture were in the mid pupillary line, while the posterior craniotomy (C3) was just lateral to the midpupillary line. At first, subdural distances measured, and then the distances from the craniotomy to the anterior, posterior, medial, and lateral directions in which endoscope could reach the farthest without the damage to the parenchyma were measured. The subdural distance was significantly deeper in C3 than C1 (P ¼ 0.001); however, there was no difference between C3 and C2 (P ¼ 0.312). The distance that could be reached with C3 was higher than C1 in anterior, posterior, lateral, and medial directions (P 0.001, 0.037, <0.001, and <0.001, respectively). The distance that could be reached with C3 was higher than C2 in anterior, posterior, lateral, and medial directions (P < 0.001, 0.02, 0.01 and <0.001, respectively). In subdural hematomas, especially that covers all surface of the hemisphere, the most suitable craniotomy is the posteriorly placed craniotomy to reach the most extended projection in anteroposterior line of the hematoma.

show abstract

Endoscopy-assisted burr hole evacuation of subdural empyema

Cited by 11 publications

References 5 publications

Hematoma cavity separation and neomembrane thickness are potential triggers of recurrence of chronic subdural hematoma

Hematoma cavity separation and neomembrane thickness are potential triggers of recurrence of chronic subdural hematoma

Smartphone-assisted minimally invasive neurosurgery

Subdural Hematoma Evacuation via Rigid Endoscopy System: A Cadaveric Study

Contact Info

Product

Resources

About