Supplementary Material for: Intracranial Navigation Using a Novel Device for Endoscope Fixation and Targeting: Technical Innovation

Intracranial endoscopy involves point-to-point navigation: first, in the introduction of the endoscope into a cerebrospinal fluid-containing space and, second, in the identification of a target structure. We report testing and preliminary clinical use of a device for the direct cranial fixation and point-to-point neuronavigation of a rigid ventricular endoscope. An 18-month-old female child presented with rapidly progressive macrocephaly, developmental delay and left hemiparesis. Neuroimaging revealed a large suprasellar cyst and obstructive hydrocephalus. We adapted a ball-stem device with an endoscopic working channel for direct cranial fixation over a burr hole. This device was successfully used in conjunction with MR-based neuronavigation to fenestrate the cyst. Seven months after the operation her developmental delay, macrocephaly and hemiparesis resolved. This device may be particularly effective in cases of small ventricles, ambiguous intra-ventricular landmarks, and in children too young for head-holder immobilization.颅内内镜术（Intracranial endoscopy）采用点对点导航模式：其一为将内镜置入含脑脊液腔隙，其二为识别目标解剖结构。本文报道了一款用于硬质脑室内镜直接颅骨固定及点对点神经导航的装置的测试与初步临床应用。一名18月龄女性患儿，表现为快速进展性巨头畸形、发育迟缓及左侧偏瘫。神经影像学检查显示存在巨大鞍上囊肿伴梗阻性脑积水。我们对一款带有内镜工作通道的球杆式装置进行了适配，使其可用于颅骨钻孔处的直接颅骨固定。该装置联合基于磁共振（MR）的神经导航技术成功完成了囊肿开窗术。术后7个月，患儿的发育迟缓、巨头畸形及偏瘫症状均得到缓解。该装置在脑室狭小、脑室内解剖标志模糊，以及因年龄过小无法使用头架固定的患儿病例中，或具有尤为突出的应用价值。