Subchoroidal approach [Neurosurgery Wiki]

This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong.
====== Subchoroidal approach ======


{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1LOe0AQBaI8MeDIG0Xl93kVOy1ETao3XMW1Ne1IY5pBwpmScvh/?limit=15&utm_campaign=pubmed-2&fc=20230328021202}}

In the presence of a dilated [[foramen of Monro]], a [[transcortical]], [[transforaminal approach]] is considered the safest and simplest [[approach]] for resection of [[colloid cyst]]s. However, in the presence of small or normal [[frontal horn]]s, numerous microsurgical approaches and, often complicated, variations have been described, invariably employing forms of stereotactic navigation.

The small frontal horn is stereotactically targeted as previously described. Routine equipment is used to accurately create a novel, rigid, atraumatic surgical corridor.

After a 7-mm corticotomy, a peel-away catheter carrying the AxiEM stylet engages the target set as the frontal horn. All joints of the endoscope holder are locked, allowing only catheter advancement (y axis) while lateral (x axis) or anteroposterior (z axis) movements are secure. Two, 7-mm retractor blades are inserted. The extremely consistent anatomy of the foramen of Monro allows en bloc microsurgical removal without unnecessary coagulation of cyst wall or choroid plexus.

Despite a plethora of approaches to the rostral [[third ventricle]], in the presence of normal or small frontal horns, including creation of [[transcallosal]]/interforniceal, [[suprachoroidal]] (or [[transchoroidal]]), and [[subchoroidal]], colloid cyst resection does not necessarily need to be convoluted. Technical nuances of an accurate, practical, minimally invasive technique are described
((Sefcikova V, Wong QH, Samandouras G. Practical, Stereotactic, Low-Profile Technique for Transcortical/Transventricular Colloid Cyst Removal Independent of Ventricular Size: Technical Note and Analysis of Approaches. Oper Neurosurg (Hagerstown). 2023 Feb 1;24(2):e61-e67. doi: 10.1227/ons.0000000000000463. Epub 2022 Dec 9. PMID: 36637308.))