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.

颅内内镜手术采用点对点导航模式：首先将内镜置入含脑脊液的腔隙，其次识别目标组织结构。本文报告了一款用于刚性脑室内镜直接颅骨固定及点对点神经导航的设备的测试与初步临床应用情况。1例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，神经影像学检查提示存在巨大鞍上囊肿与梗阻性脑积水。我们对一款带内镜工作通道的球杆式装置进行改造，使其可经颅骨钻孔实现直接颅骨固定。该装置联合基于磁共振的神经导航系统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，或可展现出尤为突出的应用效果。