Modifications of transnasal and transoral stereotactic procedures ? Technical notes

Purpose: To investigate the response and complications of iodine-125 brachytherapy for the treatment of recurrent and newly diagnosed meningiomas. Clinical cases of 2 patients treated with this method are presented. Materials and Methods: Thirteen patients with primary and recurrent intracranial meningioma were treated by frameless stereotactic implantation of iodine-125 seeds from January 1996 to June 1998. The total dose to decay ranged from 7,000 to 17,000 cGy, with a dose rate of 5–10 cGy/h. Results: All 11 evaluable patients had a decrease or stabilization in the size of their lesions as detected by MRI during follow-up. There were no acute complications. All patients who received a total dose greater than 10,000 cGy had postoperative radiation necrosis and/or vasogenic edema while only 20% of the patients who received doses of 10,000 cGy or less had radiation changes (p = 0.002). Conclusions: MRI-guided stereotactically assisted permanent implantation of iodine-125 seeds seems to be a safe, effective and noncomplicated method for the treatment of primary and recurrent meningiomas for selected patients, when doses are limited to 10,000 cGy.

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“…Iodine-125 has a half-life of 60 days and an average life of 87 days [21,22]. This makes it tolerable by intracranial arteries and brain tissues.…”

Section: Discussionmentioning

confidence: 99%

“…This makes it tolerable by intracranial arteries and brain tissues. The very low energy level also makes it possible to deliver radiation of restricted volume [22]. Other characteristics of iodine-125 include 27.4-keV and 31.4-keV X-rays and a low-energy gamma radiation of 35.5-keV photons [8,21].…”

Section: Discussionmentioning

confidence: 99%

Brachytherapy for Intracranial Meningioma Using a Permanently Implanted Iodine-125 Seed

Obasi

Barnett²,

Suh

2002

Stereotact Funct Neurosurg

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“…1 Gaining surgical access to the clivus is technically challenging; however, transoral and transnasal approaches have been well documented in the literature. [2][3][4][5][6][7][8] In the past, neurosurgeons have biopsied clival lesions using a transnasal or transoral open approach, with and without neuronavigation. Stereotactic biopsies have also been reported using a frame-based stereotactic technique.…”

mentioning

confidence: 99%

“…Stereotactic biopsies have also been reported using a frame-based stereotactic technique. 3 To the best of our knowledge, there is no report in the literature on freehand stereotactic biopsy using continuous image guidance. Here, the authors report a transoral freehand technique using continuous image guidance to biopsy a clival lesion in a 54-year-old woman with a history of breast cancer.…”

mentioning

confidence: 99%

Transoral Stereotactic Technique for Clival Biopsy

Hirschl

Miller²,

Ammirati³

2009

Skull Base

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Objective: To report a transoral freehand technique using continuous image guidance to biopsy a clival lesion. Methods: The patient was placed in a Mayfield head rest. Patient data were registered using preacquired magnetic resonance and computed tomography images, and then, under continuous image guidance, a bone biopsy instrument was advanced freehand through a transoral route into the clival lesion. Results: Bone biopsy instrumentation was successfully placed into the clival lesion. Biopsy forceps were placed through the working channel of the biopsy instrumentation and specimen was successfully retrieved from the clival mass. The patient tolerated the procedure well and the only complaint was dysphagia, which resolved in several days postoperatively. Conclusion: The transoral freehand technique with stereotactic navigation was found to be a simple, safe, fast, and effective way to biopsy a clival lesion.

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Stereotactic biopsy approach to the upper clivus through the middle fossa floor that avoids pneumatised cavities and the intradural compartment

et al. 2016

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Modifications of transnasal and transoral stereotactic procedures ? Technical notes

Cited by 5 publications

References 13 publications

Brachytherapy for Intracranial Meningioma Using a Permanently Implanted Iodine-125 Seed

Brachytherapy for Intracranial Meningioma Using a Permanently Implanted Iodine-125 Seed

Transoral Stereotactic Technique for Clival Biopsy

Stereotactic biopsy approach to the upper clivus through the middle fossa floor that avoids pneumatised cavities and the intradural compartment

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