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Pinless frameless electromagnetic image-guided neuroendoscopy in children

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Abstract

Objectives

Frameless imaged-guided neuronavigation is a useful adjunct to neuroendoscopy in paediatric patients, especially those with abnormal or complex ventricular or cyst anatomy. The development of electromagnetic neuronavigation has allowed the use of image-guided navigation in the very young patient in whom rigid fixation in cranial pins is contraindicated. The technique and the authors’ experience of its use in a series of paediatric patients are described.

Materials and methods

Nineteen paediatric patients were treated with endoscopic surgery at two paediatric neurosurgery centres over a period of 18 months. A total of 29 endoscopic procedures were performed. The cases were reviewed and surgical outcomes assessed. In all of the cases, the goal of surgery was realised successfully at the time of surgery, as confirmed by post-operative imaging. No technical failures were encountered. None of the patients suffered worsened neurological function as a result of their procedures.

Conclusion

Pinless, frameless electromagnetic neuronavigation was found to be a safe technique that can supplement endoscopic surgery in the very young patient. It allows the use of direct navigation of the endoscope in patients that are unable safely to undergo rigid cranial fixation in pins due to young age or thin skull vaults. This has proven to be a useful adjunct to neuroendoscopy in the subset of infants who have complicated or distorted ventricular anatomy and can improve the safety and accuracy of this type of surgery. It is also an alternative to optical neuronavigation in conjunction with neuroendoscopy in patients of any age.

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References

  1. Alberti O, Riegel T, Hellwig D, Bertalanffy H (2001) Frameless neuronavigation in intracranial endoscopic neurosurgery (Comment). J Neurosurg 95(3):541–543

    CAS  PubMed  Google Scholar 

  2. Harris AE, Hadjipanayis CG, Lunsford LD, Lunsford AK, Kassam AB (2005) Microsurgical removal of intraventricular lesions using endoscopic visualization and stereotactic guidance. Neurosurgery 56(1 Suppl):125–132

    Article  PubMed  Google Scholar 

  3. Karabatsou K, Hayhurst C, Buxton N, O’Brien D, Mallucci C (2007) Endoscopic management of arachnoid cysts: an advancing technique. J Neurosurg (Supplement Paediatrics) 106:455–462

    Article  Google Scholar 

  4. Mangano F, Limbrick D, Leonard J, Sung Park T, Smyth M (2006) Simultaneous image-guided and endoscopic navigation without rigid cranial fixation: application in infants: technical case report. Neurosurgery 58(operative neurosurgery supplement 2):377–378

    Google Scholar 

  5. Nonaka Y, Oi S, Samii A, Paterno V, Feigl GC, Lüdemann W, Samii M (2006) Neuronavigational neuroendoscopic surgery. Frameless free-hand maneuvering of a hand rigid-rod neuroendoscope on visualised three-dimensional computerized image guidance: trajectory to the prepontine cistern in cadaver study. Childs Nerv Syst 22:18–27

    Article  PubMed  Google Scholar 

  6. Oi S, Enchev Y (2008) Neuroendoscopic foraminal plasty of foramen of Monro. Childs Nerv Syst 24:933–942

    Article  PubMed  Google Scholar 

  7. Prat R, Galeano I (2009) Endoscopic biopsy of foramen of Monro and third ventricle lesions guided by frameless neuronavigation: usefulness and limitations. Clin Neurol Neurosurg 111(7):579–582

    Article  PubMed  Google Scholar 

  8. Reavey-Cantwell J, Bova F, Pincus D (2006) Frameless, pinless stereotactic neurosurgery in children. J Neurosurg (Supplement Paediatrics) 104:392–395

    Article  Google Scholar 

  9. Sangra M, Clark S, Hayhurst C, Mallucci C (2009) Electromagnetic-guided neuroendoscopy in the pediatric population. J Neurosurg-Paediatrics 3:325–330

    Article  Google Scholar 

  10. Schroeder HWS, Wagner W, Tschiltschke W, Gaab MR (2001) Frameless neuronavigation in intracranial endoscopic neurosurgery. J Neurosurg 94(1):72–79

    Article  CAS  PubMed  Google Scholar 

  11. Tirakotai W, Schulte D, Bauer B, Bertalanffy H, Hellwig D (2004) Neuroendoscopic surgery of intracranial cysts in adults. Childs Nerv Syst 20:824–851

    Google Scholar 

Download references

Disclosure

The authors have no financial interest in Medtronic nor its subsidiaries and received no funding from Medtronic in the preparation of this study.

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Authors and Affiliations

  1. Royal Children’s Hospital, Mater Misericordiae Children’s Hospital, Brisbane, QLD, Australia

    Jason L. McMillen, Marianne Vonau & Martin J. Wood

  2. Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia

    Jason L. McMillen

Authors
  1. Jason L. McMillen
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  2. Marianne Vonau
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  3. Martin J. Wood
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Corresponding author

Correspondence to Jason L. McMillen.

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McMillen, J.L., Vonau, M. & Wood, M.J. Pinless frameless electromagnetic image-guided neuroendoscopy in children. Childs Nerv Syst 26, 871–878 (2010). https://doi.org/10.1007/s00381-009-1074-5

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  • DOI: https://doi.org/10.1007/s00381-009-1074-5

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