Use of the NICO Myriad device for tumor and cyst removals in a developing country.

PURPOSE: To describe the use of the NICO Myriad, a new side-cutting aspiration device for the resection of tumors, in a developing country. METHODS: The 11-, 13-, and 15-ga handpieces were used to resect tumors exposed via craniotomies, and the 19-ga handpiece was used down the side channel of a Storz Oi endoscope to resect tumors exposed endoscopically. RESULTS: The Myriad was used to resect 23 tumors, including spinal cord tumors, posterior fossa tumors and pineal tumors, and the cysts associated with two craniopharyngiomas. No complications were associated with the Myriad. Handpieces that were re-sterilized in Steranios after the initial use could each be used two to four times thereafter. CONCLUSIONS: The Myriad is the first effective tumor removal device that can be introduced down the side channel of most endoscopes, greatly expanding the spectrum of tumors that can be treated endoscopically. Its minimal diameter allows better visibility in small, deep sites such as the pineal region than is usually available when ultrasonic aspirators are used. The cost of the device, and particularly the handpieces, will limit their utility in developing countries until re-usable handpieces are developed.