By Klaus Dieter Maria Resch
Endoscopic neurosurgery has no longer but reached the security and applicability of microsurgery. Endo-neuro-sonography is a brand new method geared toward making endoscopy more secure through real-time imaging and navigation potential (brain-radar). The endo-neurosonographic snapshot is a sonographic experiment on the tip of the endoscope (mini-CT) providing additional info to the endoscopic view. Endo-Neuro-Sonography is the 1st ebook in this new subject, offering suggestions and gear, anatomical good points, and the 1st medical sequence. Schematic drawings, tables and 237 figures (122 in colour) supply an actual evaluation of this system. the ultimate bankruptcy is facing destiny suggestions on minimally invasive neurosurgery and particular connection with ergonomics in neurosurgery.
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Additional resources for Transendoscopic Ultrasound for Neurosurgery
Because of the earlier long-term shunting the ventricles were small. Therefore, in this case the usual technical solution of neuronavigation was applied,which gave us the opportunity to combine neuronavigation with ENS (Figs. 29). 58 Chapter 3 Clinical Application 3 Fig. 25. A shunt system in a typical location is shown here Fig. 26. When neuronavigation is to be used various es- on plain radiographs from lateral (1) and a-p (2) views sential steps must precede the planned operation. The head must be fixed completely in a holding device (1) and equipped with a target arm (2).
2000; Yasargil 1994a–c). However, despite all efforts, intraoperative CT and MR have not yet reached online and real-time characteristics. Only X-ray and sonography fulfill the navigation requirements of real-time feedback. Sonography can moreover be used as an online technique without negative side effects. Training in sonography is necessary before some of the difficulties in interpretation of the images can be mastered (Makuuchi et al. 1998Sutcliffe 1991). If endosonography is not to lead to frustration it is most important to learn how to get a competent image.
Moreover the pons (4) and basilar artery (3) are visible Fig. 26. CPA scan. The sono-probe (1) is in the left CPA cistern (2) in contact with the pons (5) and an arachnoid membrane (3). The 7/8 bundle (4) runs towards the petrous bone (6) Illustrative Anatomical Cases 27 Fig. 27. Jugular foramen. The endoscope looks on the Fig. 28. Jugular foramen scan. The sono-probe (1) is posi- jugular foramen (3), while the sono-probe (1) is in contact with the jugular tubercle (2). Accessory nerve (4), vagus fibers (5) and glossopharyngeal nerve (6) enter their dural pores (3).
Transendoscopic Ultrasound for Neurosurgery by Klaus Dieter Maria Resch