Abstract
Purpose
To describe the use of the NICO Myriad, a new side-cutting aspiration device for the resection of tumors, in a developing country.
Methods
The 11-, 13-, and 15-ga handpieces were used to resect tumors exposed via craniotomies, and the 19-ga handpiece was used down the side channel of a Storz Oi endoscope to resect tumors exposed endoscopically.
Results
The Myriad was used to resect 23 tumors, including spinal cord tumors, posterior fosssa tumors and pineal tumors, and the cysts associated with two craniopharyngiomas. No complications were associated with the Myriad. Handpieces that were re-sterilized in Steranios after the initial use could each be used two to four times thereafter.
Conclusions
The Myriad is the first effective tumor removal device that can be introduced down the side channel of most endoscopes, greatly expanding the spectrum of tumors that can be treated endoscopically. Its minimal diameter allows better visibility in small, deep sites such as the pineal region than is usually available when ultrasonic aspirators are used. The cost of the device, and particularly the handpieces, will limit their utility in developing countries until re-usable handpieces are developed.
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References
Dlouhy BJ, Dahdaleh NS, Greenlee JDW (2011) Emerging technology in intracranial neuroendoscopy: application of the NICO Myriad. Neurosurg Focus 30(4):E6
Garcia-Navarro V, Lancman G, Guerrero-Maldonado A, Anand VK, Schwartz TH (2011) Use of a side-cutting aspiration device for resection of tumors during endoscopic endonasal approached. Neurosurg Focus 30(4):E13
Acknowledgement
We gratefully acknowledge the generous contribution of the NICO Myriad system by the Medtronic Foundation and several handpieces donated by NICO Corporation,
Conflict of interest
Dr. Albright was a grant recipient from the Medtronic Foundation, which purchased the NICO Myriad device. Dr. Okechi was the recipient from the Medtronic Foundation of support of a pediatric neurosurgery fellowship at Kijabe Hospital.
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Albright, A.L., Okechi, H. Use of the NICO Myriad device for tumor and cyst removals in a developing country. Childs Nerv Syst 28, 599–604 (2012). https://doi.org/10.1007/s00381-012-1720-1
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DOI: https://doi.org/10.1007/s00381-012-1720-1