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58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

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Waterjet dissection of the cochlear nerve: an experimental study

Wasserstrahl-Dissektion des Nervus cochlearis: eine experimentelle Untersuchung

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  • corresponding author C.A. Tschan - Neurochirurgische Klinik der Medizinischen Hochschule Hannover
  • M. Knackstedt - Neurochirurgische Klinik der Medizinischen Hochschule Hannover
  • Z. Cinibulak - Neurochirurgische Klinik der Medizinischen Hochschule Hannover
  • M. R. Gaab - Neurochirurgische Klinik des Krankenhauses Hannover Nordstadt
  • J. K. Krauss - Neurochirurgische Klinik der Medizinischen Hochschule Hannover
  • J. Oertel - Neurochirurgische Klinik des Krankenhauses Hannover Nordstadt

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocP 097

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc352.shtml

Published: April 11, 2007

© 2007 Tschan et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Waterjet dissection of brain tissue has been shown to protect intracerebral vessels. There is no previous experience, however, with its application in the dissection of cranial nerves. Therefore, we performed an experimental study to examine the effects of waterjet dissection of the cochlear nerve in rats.

Methods: Lateral suboccipital craniotomy and microsurgical preparation of the cochlear nerve was performed in 44 rats. Different water pressures were applied in subgroups with 2, 4, 6, 8 and 10 bar (n=8) and microscopically documented. Acoustic evoked potentials before and at different defined time points up to 6 weeks after operation were used to define the effect of nerve irritation as compared with the healthy contralateral side.

Results: The cochlear nerve was preserved in its integrity up to 6 bar. Water pressure of 8 bar microscopically damaged the surface of nerve. Calibration at 10 bar resulted in marked nerval damage. Time course analysis of the acoustic evoked potentials demonstrated a complete functional nerve preservation up to 8 bar after 6 weeks in all subgroups.

Conclusions: Microsurgical dissection of cranial nerves is possible by waterjet dissection while preserving both morphology and function. The present findings open new fields for waterjet dissection in neurosurgery. Waterjet dissection could be useful in skull base surgery including microvascular decompression and dissection of cranial nerves from tumors.