Carlos Eduardo da Silva1, Vinicius Duval da Silva2, Jefferson Luis Braga da Silva3. 1. Department of Neurosurgery and Skull Base Surgery, ICBC - Instituto de Cirurgia da Base do Crânio, Hospital Ernesto Dornelles, Porto Alegre, RS, Brazil. Electronic address: carlos@icbc-neurocirurgia.com.br. 2. Department of Pathology and Radiation, Pontifical Catholic University of Rio Grande do Sul - PUCRS, Porto Alegre, RS, Brazil. 3. Service of Hand Surgery and Reconstructive Microsurgery, Pontifical Catholic University of Rio Grande do Sul - PUCRS, Porto Alegre, RS, Brazil.
Abstract
OBJECTIVES: Skull base meningiomas are a neurosurgical challenge due to the involvement of neurovascular structures. In this study, the authors present the first study of the trans-operative use of sodium fluorescein (SF) to enhance skull base meningiomas and perform a quantitative digital analysis of the tumors' pigmentation. The goal of the study was to observe the SF enhancement of skull base meningiomas. PATIENTS AND METHODS: A prospective, within-subjects study was designed and performed. This study included twelve patients with skull base meningiomas. After an initial dissection, digital pictures were taken before and after systematic injections of SF using the same light-source used for the surgical microscope. These pictures were analyzed with software that calculated the wavelengths of the sodium fluorescein before and after the injection of the dye. RESULTS: The meningiomas in the sample included the following types: 1 cavernous sinus, 1 olfactory groove, 3 petroclival, 1 tuberculum sellae, 3 sphenoid wings, 1 anterior clinoid, and 2 temporal floor. The SF enhancement in all tumors was strongly positive. CONCLUSIONS: The low cost, universal availability and safety of SF indicate that this dye should be examined in further studies, and its applications in skull-base meningioma surgeries should be further assessed.
OBJECTIVES: Skull base meningiomas are a neurosurgical challenge due to the involvement of neurovascular structures. In this study, the authors present the first study of the trans-operative use of sodium fluorescein (SF) to enhance skull base meningiomas and perform a quantitative digital analysis of the tumors' pigmentation. The goal of the study was to observe the SF enhancement of skull base meningiomas. PATIENTS AND METHODS: A prospective, within-subjects study was designed and performed. This study included twelve patients with skull base meningiomas. After an initial dissection, digital pictures were taken before and after systematic injections of SF using the same light-source used for the surgical microscope. These pictures were analyzed with software that calculated the wavelengths of the sodium fluorescein before and after the injection of the dye. RESULTS: The meningiomas in the sample included the following types: 1 cavernous sinus, 1 olfactory groove, 3 petroclival, 1 tuberculum sellae, 3 sphenoid wings, 1 anterior clinoid, and 2 temporal floor. The SF enhancement in all tumors was strongly positive. CONCLUSIONS: The low cost, universal availability and safety of SF indicate that this dye should be examined in further studies, and its applications in skull-base meningioma surgeries should be further assessed.
Authors: Carlos Eduardo da Silva; Alicia Del Carmen Becerra Romero; Paulo Eduardo Peixoto de Freitas; Leonardo Desesards Olijnyk Journal: J Neurol Surg Rep Date: 2015-09-14