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. 2014 Dec;26(6):653-7.
doi: 10.3978/j.issn.1000-9604.2014.12.10.

Application of CUSA Excel ultrasonic aspiration system in resection of skull base meningiomas

Hailiang Tang  1 , Haishi Zhang  1 , Qing Xie  1 , Ye Gong  1 , Mingzhe Zheng  1 , Daijun Wang  1 , Hongda Zhu  1 , Xiancheng Chen  1 , Liangfu Zhou  1
Affiliations

Application of CUSA Excel ultrasonic aspiration system in resection of skull base meningiomas

Hailiang Tang et al. Chin J Cancer Res. 2014 Dec.

Abstract

Background: Here, we introduced our short experience on the application of a new CUSA Excel ultrasonic aspiration system, which was provided by Integra Lifesciences corporation, in skull base meningiomas resection.

Methods: Ten patients with anterior, middle skull base and sphenoid ridge meningioma were operated using the CUSA Excel ultrasonic aspiration system at the Neurosurgery Department of Shanghai Huashan Hospital from August 2014 to October 2014. There were six male and four female patients, aged from 38 to 61 years old (the mean age was 48.5 years old). Five cases with tumor located at anterior skull base, three cases with tumor on middle skull base, and two cases with tumor on sphenoid ridge.

Results: All the patents received total resection of meningiomas with the help of this new tool, and the critical brain vessels and nerves were preserved during operations. All the patients recovered well after operation.

Conclusions: This new CUSA Excel ultrasonic aspiration system has the advantage of preserving vital brain arteries and cranial nerves during skull base meningioma resection, which is very important for skull base tumor operations. This key step would ensure a well prognosis for patients. We hope the neurosurgeons would benefit from this kind of technique.

Keywords: CUSA Excel; meningiomas; skull base.

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Figures

Figure 1
Figure 1
(A) Overall view of the CUSA Excel ultrasonic aspiration system and (B) its instructions.
Figure 2
Figure 2
Preoperation and postoperation images of the patient with left sphenoid ridge and middle cranial fossa meningioma. (A,B) Pre-operative MRI images showed the meningioma was located on the left sphenoid ridge and middle skull base; (C) brain MRA indicated the left ICA and MCA were compressed by the tumor; (D,E) VR revealed the relationships of the tumor and its adjacent vessels. After “cut” partial tumor, the affected arteries were viewed clearly; (F) the intra-operative neuro-navigation system could also detect the vessels surrounding the tumor from different planes; (G) post-operation contrast MRI scan showed the tumor was completely removed. MRA, magnetic resonance angiography; ICA, internal carotid artery; MCA, middle cerebral artery; VR, virtual reality.
Figure 3
Figure 3
Intraoperative application of the CUSA Excel ultrasonic aspiration system. (A) Intraoperative use of the CUSA Excel ultrasonic aspiration system. The tumor was very close to the ICA (the white arrow indicates the surgical tip); (B) the optimal operating parameters for the use of the CUSA Excel ultrasonic aspiration system when preserving the vessels and nerves; (C) after tumor resection, the ICA (the white arrow) and optical nerve (the black arrow) were protected well. ICA, internal carotid artery.
Figure 4
Figure 4
Intraoperative application of the CUSA Excel ultrasonic aspiration system (8). During the operation, the neurosurgeons use the CUSA Excel ultrasonic aspiration system to resect the tumor. After the setup of optimal operating parameters, the brain vessels and nerves could be protected during tumor resection. Our experience is that the optimal parameters for vessel and nerve preservation are as follows: the suction is 60 Hz, the hitting power is 80 Hz, and the paramount of tissue select (++++)). Available online: http://www.asvide.com/articles/391
See this image and copyright information in PMC

References

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