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Endoscopic and Minimally Invasive Microsurgical Approaches for Treating Brain Tumor Patients

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Abstract

Recent developments in neuroendoscopy and minimally invasive procedures have greatly impacted the diagnosis and treatment of brain tumors. In this paper, we will review these innovations and discuss how they have influenced our approach to the treatment of intraventricular and pituitary tumors. Finally, the concept of keyhole neurosurgery is illustrated by discussing “eyebrow orbitotomy” approach as an example. As noninvasive therapeutic alternative become available, future neurosurgeons will be challenged to develop effective and less invasive surgical approaches for the diagnosis and treatment of patients will brain tumors.

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References

  1. Nylen CO: The microscope in aural surgery its rst use and later developments. Acta Otolaryng. (Stockholm) suppl. 116: 226–240, 1954

    CAS  Google Scholar 

  2. Rand R, Jannetta P: Microneurosurgery: application of the binocular surgical microscope in brain tumors, intra-cranial aneurysms, spinal cord disease and nerve reconstruction. Clin Neurosurg 15: 319–342, 1968

    CAS  PubMed  Google Scholar 

  3. Mixter W: Ventriculoscopy and puncture of the floor of the third ventricle. Bost Med Surg J 188: 277–278, 1923

    Google Scholar 

  4. Dandy W: Treatment of non-capsulated brain tumors by extensive resection of contiguous braintissue. Bull Johns Hopkins Hosp 33: 189–190, 1922

    Google Scholar 

  5. Perneczky A, Fries G: Endoscope-assisted brain surgery: Part 1-Evolution, basic concept, and current technique. Neurosurgery 42: 219–225, 1998

    CAS  PubMed  Google Scholar 

  6. Perneczky A, Muller-Forell W, van Lindert E, Fries G: Keyhole Concept in Neurosurgery: With Endscope-Assisted Microsurgery and Case Studies. Thieme, Stutt-gart, New York, 1999

  7. Souweidane MM, Sandberg DI, Bilsky MH, Gutin PH: Endoscopic biopsy for tumors of the third ventricle. Pediatr Neurosurg 33: 132–137, 2000

    CAS  PubMed  Google Scholar 

  8. Abdou MS, Cohen AR: Endoscopic treatment of colloid cysts of the third ventricle. Technical note and review of the literature. J Neurosurg 89: 1062–1068, 1998

    CAS  PubMed  Google Scholar 

  9. Robinson S, Cohen AR: The role of neuroendoscopy in the treatment of pineal region tumors. Surg Neurol 48: 360–365, discussion 365–367, 1997

    CAS  PubMed  Google Scholar 

  10. Fukushima T: Endoscopic biopsy of intraventricular tumors with the use of a ventriculo berscope. Neurosurgery 2: 110–113, 1978

    CAS  PubMed  Google Scholar 

  11. Macarthur DC, Buxton N, Punt J, Vloeberghs M, Robertson IJ: The role of neuroendoscopy in the management of brain tumours. Br J Neurosurg 16: 465–470, 2002

    CAS  PubMed  Google Scholar 

  12. Macarthur DC, Buxton N, Vloeberghs M, Punt J: The effectiveness of neuroendoscopic interventions in children with brain tumours. Childs Nerv Syst 17: 589–594, 2001

    CAS  PubMed  Google Scholar 

  13. Pople IK, Athanasiou TC, Sandeman DR, Coakham HB: The role of endoscopic biopsy and third ventriculostomy in the management of pineal region tumours. Br J Neurosurg 15: 305–311, 2001

    CAS  PubMed  Google Scholar 

  14. Gaab MR, Schroeder HW: Neuroendoscopic approach to intraventricular lesions. J Neurosurg 88: 496–505, 1998

    CAS  PubMed  Google Scholar 

  15. Jallo GI, Morota N, Abbott R: Introduction of a second working portal for neuroendoscopy. A technical note. Pediatr Neurosurg 24: 56–60, 1996

    CAS  PubMed  Google Scholar 

  16. Cohen AR: Endoscopic ventricular surgery. Pediatr Neurosurg 19: 127–134, 1993

    CAS  PubMed  Google Scholar 

  17. Schroeder HW, Gaab MR: Endoscopic resection of colloid cysts. Neurosurgery 51: 1441–1444, discussion 1444–1445, 2002

    PubMed  Google Scholar 

  18. Rodziewicz GS, Smith MV, Hodge CJ Jr.: Endoscopic colloid cyst surgery. Neurosurgery 46: 655–660, discussion 660–652, 2000

    CAS  PubMed  Google Scholar 

  19. King WA, Ullman JS, Frazee JG, Post KD, Bergsneider M: Endoscopic resection of colloid cysts: surgical considerations using the rigid endoscope. Neurosurgery 44: 1103–1109, discussion 1109–1111, 1999

    CAS  PubMed  Google Scholar 

  20. Lewis AI, Crone KR, Taha J, van Loveren HR, Yeh HS, Tew Jr JM: Surgical resection of third ventricle colloid cysts. Preliminary results comparing transcallosal microsurgery with endoscopy. J Neurosurg 81: 174–178, 1994

    CAS  PubMed  Google Scholar 

  21. Hellwig D, Benes L, Bertalanffy H, Bauer BL: Endoscopic stereotaxy-an eight year’s experience. Stereotact Funct Neurosurg 68: 90–97, 1997

    CAS  PubMed  Google Scholar 

  22. Decq P, Le Guerinel C, Brugieres P, Djindjian M, Silva D, Keravel Y, Melon E, Nguyen JP: Endoscopic management of colloid cysts. Neurosurgery 42: 1288–1294, discussion 1294–1286, 1998

    CAS  PubMed  Google Scholar 

  23. Mathiesen T, Grane P, Lindquist C, von Holst H: High recurrence rate following aspiration of colloid cysts in the third ventricle. J Neurosurg 78: 748–752, 1993

    CAS  PubMed  Google Scholar 

  24. Kondziolka D, Lunsford LD: Stereotactic management of colloid cysts: factors predicting success. J Neurosurg 75: 45–51, 1991

    CAS  PubMed  Google Scholar 

  25. Kondziolka D, Lunsford LD: Stereotactic techniques for colloid cysts: roles of aspiration, endoscopy, and microsurgery. Acta Neurochir Suppl (Wien) 61: 76–78, 1994

    CAS  PubMed  Google Scholar 

  26. Schloffer H: Ergolgreiche Operation eines Hypophysentumors auf nasalem Wege. Wien Klin Wochenschr 21: 621, 1907

    Google Scholar 

  27. Liu JK, Das K, Weiss MH, Laws ER Jr., Couldwell WT: The history and evolution of transsphenoidal surgery. J Neurosurg 95: 1083–1096, 2001

    CAS  PubMed  Google Scholar 

  28. Hardy J: Transsphenoidal microsurgery of the normal and pathological pituitary. Clin Neurosurg 16: 185–217, 1969

    CAS  PubMed  Google Scholar 

  29. Liu JK, Weiss MH, Couldwell WT: Surgical approaches to pituitary tumors. Neurosurg Clin N Am 14: 93–107, 2003

    PubMed  Google Scholar 

  30. Griffith HB, Veerapen R: A direct transnasal approach to the sphenoid sinus. Technical note. J Neurosurg 66: 140–142, 1987

    CAS  PubMed  Google Scholar 

  31. Guiot G, Rougerie J, Fourestler A, et al.: Une nouvelle technique endoscopique: Exploration endoscopiques intracraniennes. Presse Med 71: 1225–1228, 1963

    CAS  PubMed  Google Scholar 

  32. Jho H-D, Carrau RL: Endoscopy assisted transsphenoidal surgery for pituitary adenoma: Technical Note. Acta Neurochir (Wien) 138: 1416–1425, 1996

    CAS  Google Scholar 

  33. Kawamata T, Iseki H, Ishizaki R, Hori T: Minimally invasive endoscope-assisted endonasal trans-sphenoidal microsurgery for pituitary tumors: experience with 215 cases comparing with sublabial trans-sphenoidal approach. Neurol Res 24: 259–265, 2002

    PubMed  Google Scholar 

  34. Cappabianca P, Cavallo LM, Colao A, Del Basso De Caro M, Esposito F, Cirillo S, Lombardi G, de Divitiis E: Endoscopic endonasal transsphenoidal approach: outcome analysis of 100 consecutive procedures. Minim Invas Neurosurg 45: 193–200, 2002

    CAS  Google Scholar 

  35. Nasseri SS, Kasperbauer JL, Strome SE, McCaffrey TV, Atkinson JL, Meyer FB: Endoscopic transnasal pituitary surgery: report on 180 cases. Am J Rhinol 15: 281–287, 2001

    CAS  PubMed  Google Scholar 

  36. Jho HD, Alfieri A: Endoscopic endonasal pituitary surgery: evolution of surgical technique and equipment in 150 operations. Minim Invasive Neurosurg 44: 1–12, 2001

    CAS  PubMed  Google Scholar 

  37. Jho H-D: Endoscopic transsphenoidal surgery. J Neuro-Oncol 54: 187–195, 2001

    CAS  Google Scholar 

  38. Cappabianca P, Cavallo LM, Colao A, de Divitiis E: Surgical complications associated with the endoscopic endonasal transsphenoidal approach for pituitary adenomas. J Neurosurg 97: 293–298, 2002

    PubMed  Google Scholar 

  39. Zada G, Kelly DF, Cohan P, Wang C, Swerdloff R: Endonasal transsphenoidal approach for pituitary adenomas and other sellar lesions: an assessment of efficacy, safety, and patient impressions. J Neurosurg 98: 350–358, 2003

    PubMed  Google Scholar 

  40. Badie B, Nguyen P, Preston JK: Endoscopic-guided direct endonasal approach for pituitary surgery. Surg Neurol 53: 168–172, discussion 172–163, 2000

    CAS  PubMed  Google Scholar 

  41. Ciric I, Ragin A, Baumgartner C, Pierce D: Complications of transsphenoidal surgery: results of a national survey, review of the literature and personal experience. Neurosurgery 40: 225–237, 1997

    CAS  PubMed  Google Scholar 

  42. Yasargil MG: Microneurosurgery, vol. IVB. Thieme, Stuttgart, New York, 1996

    Google Scholar 

  43. Wilson D: Limited exposure in cerebral surgery: Technical Note. J Neurosurg 34: 102–106, 1971

    CAS  PubMed  Google Scholar 

  44. Steiger HJ, Schmid-Elsaesser R, Stummer W, Uhl E: Transorbital keyhole approach to anterior communicating artery aneurysms. Neurosurgery 48: 347–351, discussion 351–342, 2001

    CAS  PubMed  Google Scholar 

  45. Cristante L, Puchner MA: A keyhole middle fossa approach to large cholesterol granulomas of the petrous apex. Surg Neurol 53: 64–70;discussion 70–61, 2000

    CAS  PubMed  Google Scholar 

  46. Czirjak S, Nyary I, Futo J, Szeifert GT: Bilateral supra-orbital keyhole approach for multiple aneurysms via superciliary skin incisions. Surg Neurol 57: 314–323, discussion 323–314, 2002

    PubMed  Google Scholar 

  47. Fukushima T, Miyazaki S, Takusagawa Y, Reichman M: Unilateral interhemispheric keyhole approach for anterior cerebral artery aneurysms. Acta Neurochir Suppl (Wien) 53: 42–47, 1991

    CAS  Google Scholar 

  48. Grand W, Landi MK, Dare AO: Transorbital keyhole approach to anterior communicating artery aneurysms. Neurosurgery 49: 483–484, 2001

    CAS  PubMed  Google Scholar 

  49. Kocaogullar Y, Avci E, Fossett D, Caputy A: The extradural subtemporal keyhole approach to the spheno-cavernous region: anatomic considerations. Minim Invasive Neurosurg 46: 100–105, 2003

    CAS  PubMed  Google Scholar 

  50. Lin Y, Qiu Y: Microanatomy of endoscope-assisted glabellar nasal keyhole approach. Minim Invasive Neurosurg 46: 155–160, 2003

    CAS  PubMed  Google Scholar 

  51. Paladino J, Pirker N, Stimac D, Stern-Padovan R: Eyebrow keyhole approach in vascular neurosurgery. Minim Invasive Neurosurg 41: 200–203, 1998

    CAS  PubMed  Google Scholar 

  52. van Lindert E, Perneczky A, Fries G, Pierangeli E: The supraorbital keyhole approach to supratentorial aneurysms: concept and technique. Surg Neurol 49: 481–489, discussion 489–490, 1998

    CAS  PubMed  Google Scholar 

  53. Jho HD: Orbital roof craniotomy via an eyebrow incision: a simplified anterior skull base approach. Minim Invasive Neurosurg 40: 91–97, 1997

    CAS  PubMed  Google Scholar 

  54. Czirjak S, Szeifert GT: Surgical experience with fronto-lateral keyhole craniotomy through a superciliary skin incision. Neurosurgery 48: 145–149, discussion 149–150, 2001

    CAS  PubMed  Google Scholar 

  55. Sanchez-Vazquez MA, Barrera-Calatayud P, Mejia-Villela M, Palma-Silva JF, Juan-Carachure I, Gomez-Aguilar JM, Sanchez-Herrera F: Transciliary subfrontal craniotomy for anterior skull base lesions. Technical note. J Neurosurg 91: 892–896, 1999

    CAS  PubMed  Google Scholar 

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Badie, B., Brooks, N. & Souweidane, M.M. Endoscopic and Minimally Invasive Microsurgical Approaches for Treating Brain Tumor Patients. J Neurooncol 69, 209–219 (2004). https://doi.org/10.1023/B:NEON.0000041884.93566.fb

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  • DOI: https://doi.org/10.1023/B:NEON.0000041884.93566.fb

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