Surgical Instrument Tracking Optimizes Trans-Sphenoidal Endoscopic Treatment of Petrous Apex Cholesterol Granuloma

Eduard H. Voormolen; Sebastien Froelich; Peter A. Woerdeman; Jan Willem Berkelbach van der Sprenkel; Weibel W. Braunius; Luca Regli

doi:10.1055/s-0032-1326945

Journal of Neurological Surgery Part A: Central European Neurosurgery, Table of Contents

J Neurol Surg A Cent Eur Neurosurg 2013; 74(02): 109-112
DOI: 10.1055/s-0032-1326945

Technical Note

Georg Thieme Verlag KG Stuttgart · New York

Surgical Instrument Tracking Optimizes Trans-Sphenoidal Endoscopic Treatment of Petrous Apex Cholesterol Granuloma

Authors

Eduard H. Voormolen

¹Department of Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands
Sebastien Froelich

²Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France
Peter A. Woerdeman

¹Department of Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands
Jan Willem Berkelbach van der Sprenkel

¹Department of Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands
Weibel W. Braunius

³Department of Otolaryngology, University Medical Center Utrecht, Utrecht, The Netherlands
Luca Regli

¹Department of Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands

Abstract

During endoscopic trans-sphenoidal treatment of petrous apex cholesterol granuloma, the challenge for the surgeon is to drill the posterior wall of the sphenoid sinus to reach the lesion while attempting to avoid the internal carotid artery (ICA). A refined neuronavigation technique is presented that diminishes bonework needed for exposure and marsupialization, and simultaneously minimizes risks of accidental harm to the ICA. The technique utilizes real-time intraoperative instrument tracking of a drill, enabling safe creation of a direct canal toward the cyst just medial to the paraclival ICA and of a curette for entirely image-guided marsupialization of the cyst's deep areas through the canal.

Keywords

endoscopy - neuronavigation - minimal invasive - petrous bone - skull base

Full Text

References

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