RESUMO
BACKGROUND: Recent advances in neuroendoscopic surgery have led to the minimally invasive treatment of brain abscesses using various endoscopy techniques. The endoscopic diving technique (EDT) involving the formation of fluid lenses to improve the visibility of the endoscope has been reported to be useful in the endoscopic endonasal approach (EEA) for pituitary and midline cranial base lesions. Here, we report a case of brain abscess treated endoscopically using EDT in cylinder surgery. CLINICAL PRESENTATION: A 29-year-old man with 11q trisomy syndrome developed a fever and progressive right hemiparesis was observed. A diagnosis of a brain abscess was made based on neuroradiological imaging, and endoscopic irrigation and drainage with EDT via a transparent endoscopic sheath were performed, which provided a clear operative field and allowed satisfactory irrigation without bacterial contamination. The bacterium identified by PCR was Streptococcus intermedius, and antibiotic therapy was administered. Postoperatively, his symptoms gradually improved. CONCLUSION: This is the first technical case report describing the clinical experience of EDT in brain abscess surgery. EDT may be a useful technique not only in EEA but also in cylinder surgery for brain abscesses.
RESUMO
BACKGROUND: The endoscopic diving technique (EDT) is a procedure utilized in endonasal endoscopy, which consists of irrigating the surgical cavity during tumor removal, with a continuous flow of pressurized saline solution. METHODS: The authors provide a detailed step-by-step description of the technique, shedding light on surgical tips and pitfalls. Advantages, disadvantages, and the most useful application of the technique are clarified and showed with a high-quality endoscopic video. CONCLUSION: EDT represents an effective and safe procedure. It allows a wide exploration of the surgical cavity, providing tumor hydro-dissection, assisting in bleeding control, and optimizing the efficacy of endoscopic transsphenoidal surgery.