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72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

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Neuronavigated standard suboccipital retrosigmoidal approach – morphometric comparison of the microscopical and endoscopical surgical area of exposure of the brain stem

Neuronavigierter Standard subokzipitaler retrosigmoidaler Zugang – Vergleich der chirurgischen Morphometrie des mikroskopischen und endoskopischen Zugangareals zum Hirnstamm

Meeting Abstract

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  • presenting/speaker Zafer Cinibulak - Cologne Merheim Medical Center, University of Witten/Herdecke, Departement of Neurosurgery, Köln, Deutschland
  • Mihail Manu - Cologne Merheim Medical Center, University of Witten/Herdecke, Department of Neurosurgery, Köln, Deutschland
  • Nima Ostovar - Cologne Merheim Medical Center, University of Witten/Herdecke, Department of Neurosurgery, Köln, Deutschland
  • Jörg Poggenborg - Cologne Merheim Medical Center, University of Witten/Herdecke, Department of Radiology, Köln, Deutschland
  • Stefanie Schliwa - University of Bonn, Institute of Anatomy, Bonn, Deutschland
  • Makoto Nakamura - Cologne Merheim Medical Center, University of Witten/Herdecke, Departement of Neurosurgery, Köln, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocP213

doi: 10.3205/21dgnc494, urn:nbn:de:0183-21dgnc4946

Veröffentlicht: 4. Juni 2021

© 2021 Cinibulak et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Microscopical and endoscopical surgical areas of exposure in the standard suboccipital retrosigmoidal approach (SSRA) vary widely. For surgical treatments of pathologies at the brain stem, the knowledge about the surgical area of exposure plays a crucial role. The aim of the anatomical study is to evaluate and to compare the surgical area of exposure for the microscopical SSRA and the endoscopical-assisted SSRA

Methods: Three adult human cadaver heads (6 sides) underwent a neuronavigated SSRA. Microsurgical and endoscopic (0 and 30 degree-optic) vector coordinates at the brain stem were marked and noted using neuronavigation. The surgical area of exposure and the corresponding angle of attack was calculated and compared.

Results: The mean endoscopic-assisted area of exposure (428, 43 mm2 ± 26,21 mm2 (Range: 386,23 – 457,29 mm2)) was more significant than the microcopical area of exposure (338, 97 mm2 ± 24,76 mm2 (Range: 311,72 – 361,45 mm2)). Notable, the endoscope increases the view located at the ventral brain stem. However the mean angle of attack for the microscope (39,89° ± 2,56° (Range: 36,31° - 42,06°)) and for the endoscope ( 39,56° ± 2,63° (Range: 36,14° - 41,88°) were almost equal.

Conclusion: Endoscopic-assisted SSRA helps to verify the microscopical complete resection of lesions and gives more additional surgical access to lesions located ventral to the brain stem provided that safe surgical maneuverability is given under this operative setting.