Neuroendoscopic technique, less invasive than conventional methods, has been recently introduced for the fenestration of the cystic lesions of the brain in pediatric neurosurgery. However, real-time monitoring is desirable for endoscopic surgery in patients with congenital malformations where anatomical structure are distorted, aberrant blood vessels are often found and, the intracranial volume goes on changing during the procedure.
Two cases of neuroendoscopic fenestration guided by color-coded sonography were presented. The first case was a 20-day-old boy who had interhemispheric multilocular arachnoid cysts. Neuroendoscopic fenestration of the cyst wall was performed at the age of 20 days and 5 months respectively. The second case was a fourteen-year-old boy with the cyst of cavum septi pellucidi and ventric lar dilatation. During endoscopic surgery color-coded sonography showed the direction of the endoscope, the position and motion of the tip of the endscope and the site of perforation performed. The blood vessels between or around cysts were also visualized. In both cases, cystic walls were perforated successfully and cysts were shrunken.
It was indicated that color-coded sonography was useful for real-time monitoring in neuroendoscopic surgery particularly in neonates and infants.
