Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2022
Intraoperative Fluorescence With Second Window Indocyanine Green Enhances Visualization During Vestibular Schwannoma Surgery.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Peng Kevin A, Lekovic Gregory P
Аннотация
OBJECTIVE: To investigate the utility of the so-called "second window" of indocyanine green (ICG) as a near-infrared fluorescent dye for intraoperative visualization.
PATIENTS: Three patients who underwent surgical resection of vestibular schwannoma (two retrosigmoid and one middle fossa approach).
INTERVENTIONS: Patients underwent intravenous infusion of ICG at a mean dose of 4.8 mg/kg at a mean of 15.3 hours before surgical incision. Once tumor dissection began, near-infrared fluorescence was used alongside conventional operative microscopy to visualize tumor tissue.
MAIN OUTCOME MEASURES: Ability to distinguish tumor tissue from adjacent nerves.
RESULTS: Intraoperative fluorescence allowed for enhanced visualization of the tumor-nerve plane in all patients. However, the effect varied among patients, and the effect faded with increasing surgical time.
CONCLUSIONS: ICG, a well-tolerated cyanine dye, demonstrates late fluorescence hours after administration secondary to diffusion into tumor as well as normal tissues (the so-called "second window" of fluorescence). Its fluorescence in the near-infrared spectrum is a promising adjunct for enhancing visualization of tumor planes during vestibular schwannoma surgery.
PATIENTS: Three patients who underwent surgical resection of vestibular schwannoma (two retrosigmoid and one middle fossa approach).
INTERVENTIONS: Patients underwent intravenous infusion of ICG at a mean dose of 4.8 mg/kg at a mean of 15.3 hours before surgical incision. Once tumor dissection began, near-infrared fluorescence was used alongside conventional operative microscopy to visualize tumor tissue.
MAIN OUTCOME MEASURES: Ability to distinguish tumor tissue from adjacent nerves.
RESULTS: Intraoperative fluorescence allowed for enhanced visualization of the tumor-nerve plane in all patients. However, the effect varied among patients, and the effect faded with increasing surgical time.
CONCLUSIONS: ICG, a well-tolerated cyanine dye, demonstrates late fluorescence hours after administration secondary to diffusion into tumor as well as normal tissues (the so-called "second window" of fluorescence). Its fluorescence in the near-infrared spectrum is a promising adjunct for enhancing visualization of tumor planes during vestibular schwannoma surgery.