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Piezosurgery for Infra- and Supratentorial Craniotomies in Brain Tumor Surgery
- Source :
- World neurosurgery. 122
- Publication Year :
- 2018
-
Abstract
- Objective Piezoelectric surgery represents an innovative technique to perform safe and effective osteotomies and is an alternative to traditional bony tissue management using rotating or perforating instruments. We evaluated the safety and feasibility of craniotomies using an ultrasonic device that allows the selective cut of mineralized structures, avoiding damages to the vascular, dural, and parenchymal structures. Methods We analyzed a series of 300 patients (age range, 1–81 years; SD ± 15.2) who underwent elective cranial surgery for brain tumors, in which the craniotomy was performed using a piezoelectric device. Pre- and postoperative imaging, clinical notes, and intraoperative details were collected. Results There were 197 patients (66%) who underwent surgery for supratentorial tumors; the remaining 103 patients (34%) underwent surgery for infratentorial ones. Tumors involved the skull base in 125 cases. Meningiomas, gliomas, and schwannomas represented the most common histotypes. Duraplasty for dural damages was not necessary in all cases; no venous sinuses or parenchymal injuries were reported during bone work. We noted in 13 cases (4.3%) a minor dural tear, requiring only direct sutures. Bone flaps were always intact after craniotomy. No subgaleal cerebrospinal fluid (CSF) collection or CSF leak was recorded. Because of the minimal bone gap, we always achieved correct bone flap ossification. No reabsorption or mobilization of bone flap was noted. Conclusions We illustrate the feasibility and safety of a piezosurgical cutter to perform craniotomies. This alternative technique appears to be safe, with excellent cosmetic effects, adding another tool to the neurosurgical armamentarium.
- Subjects :
- Adult
Male
medicine.medical_specialty
Leak
Adolescent
medicine.medical_treatment
Epidermal Cyst
Infratentorial Neoplasms
Multimodal Imaging
Skull Base Neoplasms
03 medical and health sciences
Young Adult
0302 clinical medicine
Cerebrospinal fluid
Meningeal Neoplasms
Medicine
Humans
Piezosurgery
Child
Craniotomy
Brain tumor surgery
Aged
Retrospective Studies
Piezoelectric surgery
Aged, 80 and over
business.industry
Ossification
Infant
Supratentorial Neoplasms
Glioma
Middle Aged
Magnetic Resonance Imaging
Surgery
Skull
medicine.anatomical_structure
030220 oncology & carcinogenesis
Child, Preschool
Feasibility Studies
Female
Neurology (clinical)
medicine.symptom
business
Meningioma
Tomography, X-Ray Computed
030217 neurology & neurosurgery
Neurilemmoma
Subjects
Details
- ISSN :
- 18788769
- Volume :
- 122
- Database :
- OpenAIRE
- Journal :
- World neurosurgery
- Accession number :
- edsair.doi.dedup.....18d5f498c616c234971880db3eee06fd