Endoscopic excision of a lateral ventricular epidermoid—A case reportof a novel technique

Shetty, Arjun and Nair, Rajesh and Tripathi, Pradeep Kumar and Kumar, Vinod and Upadhyaya, Sunil (2014) Endoscopic excision of a lateral ventricular epidermoid—A case reportof a novel technique. International Journal of Surgery Case Reports, 5 (12). pp. 1135-1138. ISSN 2210-2612

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Abstract

INTRODUCTION: Epidermoids of the lateral ventricle are relatively rare tumours. As these tumours aresoft and relatively avascular, they appear to be ideally suited for endoscopic surgical excision. At presentthe instruments available are specifically designed for endoscopic intra ventricular surgeries, limitationsbeing inability to rapidly debulk the tumour and achieve adequate haemostasis. We present a case oflateral ventricular epidermoid that was excised endoscopically using a system originally designed forendoscopic disc surgery.PRESENTATION OF CASE: We describe a female patient who presented with recurrent headache and occa-sional episodes of vomiting since 6 years. Preoperative diagnosis of lateral intra ventricular epidermoidwas made with the help of an Magnetic resonance imaging (MRI) of the brain. Intraoperatively, an inci-sion was made over the right Kocher’s point and a 2.5 cm dural opening was made following a smallcraniotomy and the Destaudeau endoscope was introduced. A 30◦scope and gentle manipulation wereused to view the ventricular cavity and ensure near total excision of the tumour. Here we record thisnovel technique.DISCUSSION: Lateral intra-ventricular tumours are usually approached through a trans-cortical or intrahemispheric approach, under microscope. The use of endoscopes have been largely restricted because ofnon-availability and relative difficulty in controlling troublesome bleeding, incase of vascular tumours. CONCLUSION: A multi portal endoscope that allows use of routine pituitary instruments would enablethe surgeon to achieve haemostasis effectively and, in our opinion, should be a viable alternative tomicroscope for excision of intra ventricular tumours.

Item Type: Article
Uncontrolled Keywords: Lateral ventricular epidermoid; endoscopic excisiona.
Subjects: Medicine > KMC Manipal > Neuro Surgery
Depositing User: KMC Manipal
Date Deposited: 23 Jul 2015 04:53
Last Modified: 23 Jul 2015 04:53
URI: http://eprints.manipal.edu/id/eprint/143466

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