[en] [en] INTRODUCTION: Intraoperative fluorescence guidance is a well-established surgical adjunct in high-grade glioma surgery. In contrast, the clinical use of such dyes and technology has been scarcely reported in skull base surgery.
RESEARCH QUESTION: We aimed to systematically review the clinical applications of different fluorophores in both open and endonasal skull base surgery.
MATERIAL AND METHODS: We performed a systematic review and discussed the current literature on fluorescence guidance in skull base surgery.
RESULTS: After a comprehensive literature search, 77 articles on skull base fluorescence guidance were evaluated. A qualitative analysis of the articles is presented, discussing clinical indications and current controversies. The use of intrathecal fluorescein was the most frequently reported in the literature. Beyond that, 5-ALA and ICG were two other fluorescent dyes most extensively discussed, with some experimental fluorophore applications in skull base surgery.
DISCUSSION AND CONCLUSION: Intraoperative fluorescence imaging can serve as an adjunct technology in skull base surgery. The scope of initial indications of these fluorophores has expanded beyond malignant glioma resection alone. We discuss current use and controversies and present an extensive overview of additional indications for fluorescence imaging in skull base pathologies. Further quantitative studies will be needed in the future, focusing on tissue selectivity and time-dependency of the different fluorophores currently commercially available, as well as the development of new compounds to expand applications and facilitate skull base surgeries.
Disciplines :
Surgery
Author, co-author :
Suero Molina, Eric ; Department of Neurosurgery, University Hospital of Münster, Münster, Germany ; Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
Bruneau, Michael; Department of Neurosurgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
Reuter, Gilles ; Université de Liège - ULiège > Département des sciences cliniques
Shahein, Mostafa ; Department of Neurosurgery, Mansoura University, Egypt
Cavallo, Luigi M; Department of Neurosciences and Reproductive and Dental Sciences, Division of Neurosurgery, Federico II University of Naples, Policlinico Federico II University Hospital, Italy
Daniel, Roy T; Department of Neurosurgery, Department of Neuroscience, Centre Hospitalier Universitaire Vaudois, University Hospital Lausanne, Switzerland
Kasper, Ekkehard M ; Department of Neurosurgery, Boston University Medical School, MA and Steward Medical Group, Brighton, MA/USA McMaster University Faculty of Health Sciences, Hamilton, ON, Canada
Froelich, Sebastien; Department of Neurosurgery, Lariboisière Hospital, Université Paris Diderot, Paris, France
Jouanneau, Emanuel; Department of Neurosurgery, Hôpital Neurologique Pierre Wertheimer, Lyon, France
Manet, Romain ; Department of Neurosurgery, Hôpital Neurologique Pierre Wertheimer, Lyon, France
Messerer, Mahmoud; Department of Neurosciences and Reproductive and Dental Sciences, Division of Neurosurgery, Federico II University of Naples, Policlinico Federico II University Hospital, Italy
Mazzatenta, Diego ; Department of Neurosurgery, Neurological Sciences Institut IRCCS, Bologna, Italy
Meling, Torstein R ; Department of Neurosurgery, The National Hospital, Rigshospitalet, Copenhagen, Denmark
Roche, Pierre-Hugues; Department of Neurosurgery, Aix-Marseille Université, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Marseille, France
Schroeder, Henry Ws; Department of Neurosurgery, University Medicine Greifswald, Germany
Tatagiba, Marcos; Department of Neurosurgery, University Hospital Tübingen, Tübingen, Germany
Visocchi, Massimiliano; Department of Neurosurgery, Institute of Neurosurgery Catholic University of Rome, Italy
Prevedello, Daniel M; Deparmtent of Neurosurgery, The Ohio State University College of Medicine, Columbus, OH, USA
Stummer, Walter; Department of Neurosurgery, University Hospital of Münster, Münster, Germany
Cornelius, Jan F ; Department of Neurosurgery, University Hospital of Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
We would like to acknowledge Santhosh George Thomas from the Department of Neurosurgery at Macquarie University Hospital, Sydney, Australia for providing the intraoperative fluorescein figure.
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