Intraoperative ultrasonography in microsurgical resection of vestibular schwannomas via retrosigmoid approach : surgical technique and proof-of-concept illustrative case series
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature..
PURPOSE: Intraoperative ultrasonography (ioUS) is an established tool for the real-time intraoperative orientation and resection control in intra-axial oncological neurosurgery. Conversely, reports about its implementation in the resection of vestibular schwannomas (VS) are scarce. The aim of this study is to describe the role of ioUS in microsurgical resection of VS.
METHODS: ioUS (Craniotomy Transducer N13C5, BK5000, B Freq 8 MHz, BK Medical, Burlington, MA, USA) is integrated into the surgical workflow according to a 4-step protocol (transdural preresection, intradural debulking control, intradural resection control, transdural postclosure). Illustrative cases of patients undergoing VS resection through a retrosigmoid approach with the use of ioUS are showed to illustrate advantages and pitfalls of the technique.
RESULTS: ioUS allows clear transdural identification of the VS and its relationships with surgically relevant structures of the posterior fossa and of the cerebellopontine cistern prior to dural opening. Intradural ioUS reliably estimates the extent of tumor debulking, thereby helping in the choice of the right moment to start peripheral preparation and in the optimization of the extent of resection in those cases where subtotal resection is the ultimate goal of surgery. Transdural postclosure ioUS accurately depicts surgical situs.
CONCLUSION: ioUS is a cost-effective, safe, and easy-to-use intraoperative adjunctive tool that can provide a significant assistance during VS surgery. It can potentially improve patient safety and reduce complication rates. Its efficacy on clinical outcomes, operative time, and complication rate should be validated in further studies.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:166 |
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| Enthalten in: |
Acta neurochirurgica - 166(2024), 1 vom: 30. Jan., Seite 55 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Carretta, Alessandro [VerfasserIn] |
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| Links: |
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| Themen: |
Acoustic neuroma |
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| Anmerkungen: |
Date Completed 31.01.2024 Date Revised 31.01.2024 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00701-024-05962-x |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM367797348 |
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| 245 | 1 | 0 | |a Intraoperative ultrasonography in microsurgical resection of vestibular schwannomas via retrosigmoid approach |b surgical technique and proof-of-concept illustrative case series |
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| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature. | ||
| 520 | |a PURPOSE: Intraoperative ultrasonography (ioUS) is an established tool for the real-time intraoperative orientation and resection control in intra-axial oncological neurosurgery. Conversely, reports about its implementation in the resection of vestibular schwannomas (VS) are scarce. The aim of this study is to describe the role of ioUS in microsurgical resection of VS | ||
| 520 | |a METHODS: ioUS (Craniotomy Transducer N13C5, BK5000, B Freq 8 MHz, BK Medical, Burlington, MA, USA) is integrated into the surgical workflow according to a 4-step protocol (transdural preresection, intradural debulking control, intradural resection control, transdural postclosure). Illustrative cases of patients undergoing VS resection through a retrosigmoid approach with the use of ioUS are showed to illustrate advantages and pitfalls of the technique | ||
| 520 | |a RESULTS: ioUS allows clear transdural identification of the VS and its relationships with surgically relevant structures of the posterior fossa and of the cerebellopontine cistern prior to dural opening. Intradural ioUS reliably estimates the extent of tumor debulking, thereby helping in the choice of the right moment to start peripheral preparation and in the optimization of the extent of resection in those cases where subtotal resection is the ultimate goal of surgery. Transdural postclosure ioUS accurately depicts surgical situs | ||
| 520 | |a CONCLUSION: ioUS is a cost-effective, safe, and easy-to-use intraoperative adjunctive tool that can provide a significant assistance during VS surgery. It can potentially improve patient safety and reduce complication rates. Its efficacy on clinical outcomes, operative time, and complication rate should be validated in further studies | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acoustic neuroma | |
| 650 | 4 | |a Complications | |
| 650 | 4 | |a Retrosigmoid | |
| 650 | 4 | |a Ultrasonography | |
| 650 | 4 | |a Ultrasound | |
| 650 | 4 | |a Vestibular schwannoma | |
| 700 | 1 | |a Voglis, Stefanos |e verfasserin |4 aut | |
| 700 | 1 | |a Röösli, Christof |e verfasserin |4 aut | |
| 700 | 1 | |a Mazzatenta, Diego |e verfasserin |4 aut | |
| 700 | 1 | |a Krayenbühl, Niklaus |e verfasserin |4 aut | |
| 700 | 1 | |a Huber, Alexander |e verfasserin |4 aut | |
| 700 | 1 | |a Regli, Luca |e verfasserin |4 aut | |
| 700 | 1 | |a Serra, Carlo |e verfasserin |4 aut | |
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