Endoscopic and endoscopically assisted surgeries for posterior cranial fossa lesions.

Document Type : Original Article

Authors

1 Neurosurgery department, Faculty of Medicine, Zagazig University, Egypt

2 Neurosurgery department, Faculty of Medicine, Zagazig University, Egypt.

Abstract

Background: posterior cranial fossa basal lesions including tumors and vascular compression syndromes especially located in cerebellopontine angles are considered one of the most complex regions due to crowded anatomy and limitations of visualization during surgery by the microscope alone, so endoscopic use as assisted technique helps in achieving good results, better outcomes and less morbidities.
Objectives: The aim is to assess endoscopic role as assisted tool during microscopic surgery for these lesions in neurosurgery Department, Zagazig University Hospitals from October 2016 to October 2018.
Patients and methods: 33 patients included 5 cases of epidermoid, 8 cases of acoustic Schwannomas, 4 meningiomas, 10 cases of Hemifacial spasm and 6 cases of trigeminal neuralgia. in this study we used the endoscope as assisted tool to the microscope, initial dissection by the microscope then the endoscope was used to navigate the area to detect and demonstrate the pathology and its relations to the surrounding structures, then most of the work is microscopic and the endoscope is used in different stages to detect any residuals of tumors, hidden parts, any injuries, may be used to dissect in some situations, position of insulators in microvascular decompression.
Results: Endoscopy provided improved visualization of local anatomy, revealed hidden lesions and reduced unnecessary anatomical distortions.
Conclusion: endoscopic aided technique greatly helps surgical management of CPA lesions and other disorders. The use of the endoscope in the CPA as a tool to increase the extent of resection, minimize complications, and preserve the function of the delicate CPA structures

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