The Role of Endoscopic Assistance in Ambient Cistern Surgery: Analysis of Four Surgical Approaches

World Neurosurgery
Eberval G FigueiredoMark C Preul

Abstract

We used microscopy with endoscopic assistance to conduct an objective analysis of 4 surgical approaches commonly used in the surgery of the ambient cistern: infratentorial supracerebellar (SC), occipital interhemispheric (OI), subtemporal (ST), and transchoroideal (TC). In addition, we performed a parahippocampalis gyrus resection in the ST context. Each approach (SC, OI, ST, TC) was performed on 3 cadaveric heads (6 sides). After the microscopic anatomic dissection, the 30-degree endoscope was used to explore the exposure. The parahippocampalis gyrus was resected through an ST approach and the exposure was evaluated. The quantitative analysis was based on linear exposure of the vascular structures (linear exposure), such as the posterior choroidal artery (PChA), the P2 and P3 segments of the posterior cerebral artery (PCA) with their branches, the basal vein of Rosenthal, and the area of exposure of the ambient cistern region (area of exposure) limited by points on its superior, mesial, and anterior walls. In all cases, a P value of less than 0.05 was considered significant. There was a significant difference (P < 0.05) in linear exposure of the PCA and medial PChA between microsurgery and endoscopic assistance using the ST ap...Continue Reading

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Citations

Jul 27, 2021·Journal of Neurological Surgery. Part B, Skull Base·André Beer-FurlanAldo Cassol Stamm

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