gms | German Medical Science

64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. - 29. Mai 2013, Düsseldorf

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High-frequency intraoperative ultrasound (ioUS) guided surgery of superficial intracerebral lesions via a single burr hole approach

Meeting Abstract

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  • Jan-Karl Burkhardt - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Carlo Serra - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Marian C. Neidert - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Claudia M. Fischer - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Christoph M. Woernle - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Oliver Bozinov - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocMO.14.04

doi: 10.3205/13dgnc120, urn:nbn:de:0183-13dgnc1208

Veröffentlicht: 21. Mai 2013

© 2013 Burkhardt et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

Gliederung

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Objective: In this study, we analyzed the feasibility of minimizing the surgical approach to a single burr hole in the surgery of superficial intracerebral lesions with the use of high-frequency intraoperative ultrasound (hfioUS).

Method: Using a standard navigation system, placement of a single burr hole was performed and ultrasound scanning with the L15-7 hfioUS probe (iU22 Ultrasound System, Philips) was used through the burr hole to display the lesion in real-time intermittently throughout the entire procedure. In a cohort of 19 consecutive patients 20 various intracerebral lesions including metastasis (n=8), gliomas (n=6), infections (n=4), lymphoma (n=1) and cavernoma (n=1) were operated on using this technique.

Results: In all 19 patients (12 male, 7 female; mean age 53.9 ± 17.1 years), lesions could be localized and resected/biopsied instantly, while preserving adjacent vessels. Lesions were located all supratentorial in the temporal (n=8), frontal (n=6), parietal (n=5) and occipital (n=1) lobe. Mean size of the lesions was 6 ± 6.7 cm2 with a mean cortex surface-to-lesion distance (CSLD) of 0.5 cm ± 0.7 cm and the mean operating time was 62 ± 26 minutes. We aimed for gross-total resection in 10 lesions (7 metastasis, 2 gliomas and 1 cavernoma) with a mean size of 1.9 ± 1.6 cm2 and a mean CSLD of 0.2 ± 0.4 cm. In all 10 cases, complete resection was achieved and confirmed. Abscess drainage (n=2) showed a postoperative volume reduction of 49% and 39% with a CSLD of 0.7 and 1.8 cm, respectively. Biopsy in the remaining 8 cases led to a histopathological diagnosis in all cases.

Conclusions: The localization and resection of various intracerebral lesions with the guidance of hfioUS via a single burr hole approach was feasible in this study. Complete resection of small and superficial lesions was achieved and abscess drainage was displayed in real-time. No postoperative complications occurred with fast surgical and recovery time leading to a favorable starting position for adjuvant therapy.