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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2021; 40(02): e113-e119
DOI: 10.1055/s-0040-1722243
Original Article | Artigo Original

Utility of Intraoperative Ultrasound in Neurosurgery

Utilidade do ultrassom intraoperatório em neurocirurgia
Gustavo Enrique Faria Méndez 
1   Department of Neurosurgery, Hospital Universitario de Caracas, Caracas, Venezuela
,
César José Roa Chacón
1   Department of Neurosurgery, Hospital Universitario de Caracas, Caracas, Venezuela
,
Nafxiel Jesus Brito Núñez 
1   Department of Neurosurgery, Hospital Universitario de Caracas, Caracas, Venezuela
,
José Ramón Zerpa
1   Department of Neurosurgery, Hospital Universitario de Caracas, Caracas, Venezuela
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Abstract

Objective The purpose of the present study is to demonstrate the usefulness of intraoperative ultrasound guidance as a technique for the assessment, in real time, of tumor resection and as a navigation aid during intra-axial brain lesion removal on patients admitted in the Neurosurgical Department at the Hospital Universitario de Caracas, Caracas, Venezuela, in 2018.

Methods A total of 10 patients were enrolled, each with intra-axial brain lesions with no previous neurosurgical procedures and a mean age of 49 years old, ranging from 29 to 59 years old.

Results A male predominance was observed with 7 cases (70%) over 3 female cases (30%). Six patients had lesions in the dominant hemisphere. The frontal lobe was the most commonly affected, with 5 cases, followed by the parietal lobe, with 4 cases. After craniotomy, ultrasound evaluation was performed previously to dural opening, during tumor resection and after tumor removal. The mean tumor size in axial, coronal and sagittal views was 3.72 cm, 3.08 cm and 3.00 cm, respectively, previously to dural opening with intraoperative ultrasound. The average tumor depth was 1.73 cm from the cerebral cortex. The location and removal duration from the beginning of the approach (ultrasound usage time) was 83.60 minutes, and the average surgery duration was 201 minutes. Navigation with intraoperative ultrasound served to resect intra-axial tumors more precisely and safely. There was no postoperative complication associated with the surgery in this series of cases.

Conclusions Intraoperative ultrasound guidance for intra-axial subcortical tumor resection is a technique that serves as a surgical and anatomical orientation tool.

Resumo

Objetivo O objetivo do presente estudo é demonstrar a utilidade da orientação ultrassonográfica intraoperatória como técnica de avaliação, em tempo real, da ressecção tumoral e como auxiliar de navegação na remoção de lesão cerebral intra-axial em pacientes internados no Serviço de Neurocirurgia do Hospital Hospital Universitario de Caracas, Caracas, Venezuela, em 2018.

Métodos Foram incluídos 10 pacientes, cada um com lesões cerebrais intra-axiais, sem procedimentos neurocirúrgicos prévios e idade média de 49 anos, variando de 29 a 59 anos.

Resultados Foi observada predominância do sexo masculino com 7 casos (70%) sobre 3 casos do sexo feminino (30%). Seis pacientes tinham lesões no hemisfério dominante. O lobo frontal foi o mais acometido, com 5 casos, seguido do lobo parietal, com 4 casos. Após a craniotomia, a avaliação ultrassonográfica foi realizada previamente à abertura dural, durante a ressecção do tumor e após a retirada do tumor. O tamanho médio do tumor nas incidências axial, coronal e sagital foi de 3,72 cm, 3,08 cm e 3,00 cm, respectivamente, previamente à abertura dural com ultrassom intraoperatório. A profundidade média do tumor foi de 1,73 cm do córtex cerebral. O tempo de localização e remoção desde o início da abordagem (tempo de utilização do ultrassom) foi de 83,60 minutos, e o tempo médio de cirurgia foi de 201 minutos. A navegação com ultrassom intraoperatório serviu para ressecar tumores intra-axiais com mais precisão e segurança. Não houve complicações pós-operatórias associadas à cirurgia nesta série de casos.

Conclusões A orientação ultrassonográfica intraoperatória para ressecção de tumor subcortical intra-axial é uma técnica que serve como ferramenta de orientação cirúrgica e anatômica.

Keywords

intraoperative ultrasound - brain tumor - glioma surgery

Palavras-chave

ultrassom intraoperatório - tumor cerebral - cirurgia de glioma

Sources of Financial and Material Support

The present research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.




Publication History

Received: 21 August 2020

Accepted: 16 November 2020

Article published online:
15 February 2021

© 2021. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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