engleski

Contact ultrasonic microprobe in pediatric neuroendoscopy

Objective: the role of endoscopic procedures in adult and pediatric neurosurgery is growing. the different neuroendoscopic instruments and techniques for the membrane penetration and tumor removal have been developed such as blunt perforation, endoscopic scissors and forceps, mono and bipolar electrocoagulation and laser. We report our experience with originally constructed contact ultrasonic microprobe "NECUP-2" in neuronedoscopy. Methods: the newly developed "NECUP-2" consists of the ultrasound generator (amplitude 300 micrometars, intensity 900 W/cm2, acceleration 400000 m/s2, frequency 25000 Hz), and titanium microprobe with 1, 6 mm diameter which easily passes through the 2, 2 mm ventriculoscope working channel. the ultrasound intensity can be changed from low to high enabling tissue perforation and removal with preserving vascular structures. Results: Between June 1997 and June 2006, 120 patients (aged 1 month to 78 years) were treated by neuroendoscopy: 90 ETV, 10 septostomies, 15 arachnoid cysts and five intraventricular tumors. The "NECUP-2" was applied in all cases in which blunt perforation was not possible: 30/90 ETV, 10/10 septostomies, 15/15 arachnoid cysts. In five cases of intraventricular tumor neuroendoscopic procedure was combined with open microsurgery. The "NECUP-2" was highly effective in all cases enabling safe fenestration and tumor removal with preservation of vascular structures. There were not "NECUP-2" related complications. Conclusion: Our preliminary results demonstrate that the application of the "NECUP-2" in neuroendoscopic procedures is effective and safe and can be useful addition to standard neuroendoscopic instruments and techniques in adult and pediatric patient population.

high energy ultrasound; neuroendoscopy; third ventriculostomy

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