Clinical Value of 3D-Printed Navigation Technology Combined with Neuroendoscopy for Intracerebral Hemorrhage.

Intracerebral hemorrhage (ICH) is the most common form of hemorrhagic stroke with high morbidity and mortality. Rapid and massive bleeding may compress the brain tissue, causing space-occupying and pathological effects, such as reduced local cerebral blood flow, acidosis, and inflammatory and immune responses. Although the development of minimally invasive technique provides a new option for the treatment of ICH, their application is limited due to the difficulty in achieving accurate puncture localization under the guidance of the marks on CT. We selected 30 patients treated with neuroendoscopic surgery guided by 3D-printed navigation technology (experimental group) and 30 patients treated with neuroendoscopic surgery guided by hand-painted on the patient's body surface according to the marks on CT (control group). Our results showed that patients in the experimental group had a lower number of intraoperative punctures, shorter operation time, less intraoperative blood loss, higher hematoma clearance rate, and smaller volume of perihematomal edema than the patients in the control group. Moreover, patients in the experimental group had higher Glasgow Coma Scale score at discharge, shorter postoperative hospitalization time and ICU stay, and a lower rate of postoperative complications, despite the lack of statistically significant differences. In addition, no statistically significant differences were observed in mortality and Glasgow Outcome Scale score between the two groups. In conclusion, 3D-printed navigation technology used for the neuroendoscopic hematoma removal is a more reliable and less invasive approach in the treatment of ICH. This technique has great application prospects and deserves promotion in the future clinical practice.

3D-printed model-guided endoscopic evacuation for basal ganglia hemorrhage.

The purpose of this study was to investigate the effectiveness and practicality of 3D-printed model-guided endoscopic surgery for the treatment of basal ganglia hemorrhage. The authors retrospectively analyzed the data of all patients who underwent endoscopic evacuation of basal ganglia hemorrhage in the Department of Neurosurgery at Dalang Hospital and Shipai Hospital between December 2017 and February 2019. Twelve patients, in whom the 3D-printed model guidance was used for endoscopic evacuation, were included in this investigation. Using 3D reconstructed technology, we designed the appropriate surgical approach. Then, an individualized facial model with the guide orifice was printed by a 3D printer. Further, the 3D-printed model was employed to guide the insertion of the endoscope sheath. As a result, the average evacuation rate was 97.2% (range 90.1-100.0%). The GCS and mRS score were improved in each patient from admission to discharge examination. All patients had a good prognosis based on their functional independence measure (FIM) scores at the 6-month follow-up. The 3D-printed model-guided endoscopic evacuation was effective and safe for basal ganglia hemorrhage. This technique deserves further investigation to determine its role in intracerebral hemorrhage management.