To Discuss Of Symptomatic Septum Pellucidum By The Application Of Neuronavigation Assisted Neuroendoscopic Half Ventriculostomy

Objective To discuss the techniques and significance of the application of neuronavigation assisted neuroendoscopic treatment for symptomatic septum pellucidum cysts. Be that the mass curing the technology and patient life provides scientific basis for improve a disease.Methods Under the guide of neuronavigation, surgical plan including optimal skin incision and approach was accomplished, in 20 cases with septum pellucidum cysts. During the surgical operation, the trajectory of endoscopy was monitored and guided in real time and dynamically by neuronavigation system. A total of 20 patients with symptomatic septum pellucidum cysts were given a cyst - lateral ventricle half ventriculostomy via a transcallosal and transventricular approach by using a neuronavigation assisted neuroendoscope. Preoperative estimate that, the postoperative follow-up the regular intervals, analyses patient operation and the postoperative follow-up data.Results 1,Surgical result:All of the 20 cases were treated with fenestration ventriculostomy on the right wall of septum pellucidum cyst by passing the right frontal eminence. The diameter of the fenestration circle was 6~10mm and the cyst fluid was involved in the normal circulation of cerebrospinal fluid. At 1st day and 2nd day post surgery, all 20 patients had a temperature higher than 37℃. The patients left hospital seven days after surgery. All of the self-reported symptoms of the patients disappeared. The fundus examinations of 7 cases with papilledema before surgery were normal. The CT reexamination of 2 cases complicated with hydrocephalus showed that hydrocephalus disappeared and they were given antiepileptic drugs when they left hospital. 2,Postoperative follow-up:Six months, twelve months and eighteen months after surgery, the follow-up reexamination of craniocerebral CT or MRI showed that the fenestration on the right wall of the cyst existed. The transverse diameter of cyst reduced by 50% in 4 cases, 50-90% in 13 cases and 30-50% in 2 cases. The reduction was not obvious is one case and the two sides of cyst were straight; foramen of Monro on the side ventricles of the brain was unblocked and there was no cyst recurrence (Attached drawing 1, A, B septum pellucidum cyst before surgery; C, D septum pellucidum cyst reduced after surgery, foramen of Monro was unblocked). As for the 13 cases with a major sign of intracranial hypertension, the symptoms quickly disappeared after surgery. Two cases had occasional dizziness and the two cases of visual loss had obvious improvement 6~12 months after surgery. Of two patients with mental symptoms, one returned to the normal mental condition after 1 year, while the other had paraphasia and logic disorder even at 6th month after surgery. Among the 11 cases of epilepsy, 8 cases continued to take antiepileptic drugs regularly after surgery with 4 cases of occasional attacks and 4 cases of no attack; 3 cases didn't take drugs regularly with one case of frequent attacks and one case of occasional attacks. 3,statistics analysis result: This group 20 example patients (material from literature) do not have the difference with 20 example two-sided cyst wall windowing patient on the surgery curative effect statistics analysis .Conclusions The application of neuronavigation assisted neuroendoscopic cyst– lateral ventricle half ventriculostomy for septum pellucidum cysts is a safe, effective, and minimally invasive operation, but patient with epilepsy attacks had poor effect. 1,The SSPC operation indication ought to think that image data and clinical symptoms synthetically. 2,The curative effect appraises operation: the symptom of intracranial hypertension can be prompt with sending out secondary hydrocephalus then laxation, disappear, the operation curative effect makes an ideal clear.The epilepsy symptom operation effect is not ideal. 3,Postoperative existence complication: fever heat , the puncture way that the bleeding , the injury cerebral cortex cause epilepsy to happen. 4,At present, nervenavigation system assists nerveendoscope application to be a preferred plan for operation .