Emerging technology in intracranial neuroendoscopy: application of the NICO Myriad
Emerging technology in intracranial neuroendoscopy: application of the NICO Myriad
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DOI：
10.3171/2011.2.focus10312
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发表时间：
2011-04-01
影响因子：
4.1
通讯作者：
Greenlee, Jeremy D. W.
中科院分区：
文献类型：
--
作者：
Dlouhy, Brian J.;Dahdaleh, Nader S.;Greenlee, Jeremy D. W.
光纤和成像技术的进步为神经内镜的巨大进步铺平了道路。这些进步导致内窥镜在神经外科手术中的使用越来越广泛，这反过来又引发了一场技术革命，导致新的方法、仪器、技术和用于治疗各种神经外科疾病的多样化医疗设备。软组织切除通常是内窥镜手术的限速方面，特别是当软组织致密或纤维化时。作者回顾了一系列病例，涉及2009年8月至2010年10月期间使用新器械（NICO Myriad）治疗的患者，该器械是一种非发热、振荡、切割和组织切除工具，可通过内窥镜的工作通道使用，也可用于开放性神经外科手术。他们在14例单纯内窥镜颅内手术和1例内窥镜辅助锁孔开颅术中使用了该器械。他们报告称，该器械易于使用，并发现组织切除比其他可用内窥镜器械更有效，尤其是在纤维化组织切除方面。未观察到器械相关并发症。作者讨论了在内窥镜下切除垂体瘤、颅咽管瘤和胶样囊肿中使用该器械的技术方面。他们还证明了其在脑积水和脑室内凝块清除中的用途，并讨论了其在其他神经外科疾病中的潜在用途。(DOI：10.3171/2011.2.FOC10312）
Improvement in fiber optics and imaging paved the way for tremendous advancements in neuroendoscopy. These advancements have led to increasingly widespread use of the endoscope in neurosurgical procedures, which in turn incited a technological revolution leading to new approaches, instruments, techniques, and a diverse armamentarium for the treatment of a variety of neurosurgical disorders. Soft-tissue removal is often a rate-limiting aspect to endoscopic procedures, especially when the soft tissue is dense or fibrous. The authors review a series of cases involving patients treated between August 2009 and October 2010 with a new device (the NICO Myriad), a non-heat-generating, oscillating, cutting, and tissue removal instrument that can be used through the working channel of the endoscope as well as in open neurosurgical procedures. They used this device in 14 purely endoscopic intracranial procedures and 1 endoscope-assisted keyhole craniotomy. They report that the device was easy to use and found that tissue resection was more efficient than with other available endoscopic instruments, especially in the resection of fibrotic tissue. There were no observed device-related complications. The authors discuss the technical aspects of using this device in endoscopic resection of pituitary tumors, craniopharyngiomas, and colloid cysts. They also demonstrate its use in hydrocephalus and intraventricular clot removal and discuss its potential use in other neurosurgical disorders. (DOI: 10.3171/2011.2.FOCUS10312)