Case Series
 
Novel adaptation of the AxiEM electromagnetic neuronavigation system for intraoperative tracking of neuroendoscope during intraventricular surgery
Irene Say1, Rachana Tyagi2, Smit Shah2
1Rutgers, New Jersey Medical School, Department of Neurosurgery, Newark, New Jersey, USA
2Rutgers Robert Wood Johnson University Hospital, Department of Neurosurgery, New Brunswick, New Jersey, USA

Article ID: Z01201801CS10094IS
doi: 10.5348/ijcri-201801-CS-10094

Corresponding Author:
Smit Shah,
112 Montgomery Street, Apt 3G,
City: Highland Park,
New Jersey,
USA - 08904

Access full text article on other devices

  Access PDF of article on other devices

[Abstract HTML]   [Full Text HTML]   [Full Text PDF]   [Print This Article]
[Similar article in Pumed] [Similar article in Google Scholar]


How to cite this article
Say I, Tyagi R, Shah S. Novel adaptation of the AxiEM electromagnetic neuronavigation system for intraoperative tracking of neuroendoscope during intraventricular surgery. Int J Case Rep Images 2018;9(1):9–15.


ABSTRACT

Introduction: Endoscopic third ventriculostomy is a minimally invasive neurosurgical procedure which is the most commonly used to treat hydrocephalus via creating an opening in the floor of the third ventricle which allows excess cerebrospinal fluid to flow into surrounding basal cisterns by bypassing obstructions. Use of electromagnetic (AxiEM) neuronavigation to assess precise anatomical landmarks intraoperatively is gaining more importance to achieve accurate results. Endoscopic third ventriculostomy and neuroendoscopic intraventricular surgery overcome the persistent risk of infection and hardware failure associated with ventriculoperitoneal shunting for the treatment of hydrocephalus. However, the surgical technique is associated with endoscopic third ventriculostomy (ETV) risks neurovascular catastrophe.
Case Series: The aim of this case series is to assess the safety and effectiveness in surgical outcomes of adding neuronavigation tracking to endoscopic visualization for intraventricular surgery. A retrospective chart review (case series) of adult and pediatric patients treated with neuronavigation-guided endoscopic third ventriculostomy (ETV) or intraventricular cyst fenestration for radiographically confirmed and clinically significant congenital or acquired hydrocephalus in university hospital setting between 2012–2014; n = 21 patients was performed. Herein, we present our surgical outcomes and complications with an average follow-up of 20 months.
Conclusion: Intraoperative neuronavigation provides a safe corridor for neuroendoscopy and avoids the complications of skull fixation in both adult and pediatric patients. Adding image guidance to neuroendoscopy increases safety margins for targeting accuracy, especially for patients with challenging anatomic landmarks.

Keywords: Electromagnetic, Endoscopic, Neuronavigation, Shunt, Ventriculoperitoneal, Ventriculostomy


[Abstract HTML]   [Full Text HTML]   [Full Text PDF]

Author Contributions
Irene Say – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Rachana Tyagi – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Smit Shah – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of Submission
The corresponding author is the guarantor of submission.
Source of Support
None
Conflict of Interest
Authors declare no conflict of interest.
Copyright
© 2018 Irene Say et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.