Pressure monitoring during neuroendoscopy: new insights

Abstract

During endoscopy, measurements at the rinsing inlet overestimated the ventricular pressure by ∼50 mm Hg during heavy rinsing, whereas measurements at the rinsing outlet underestimated the pressure by ∼50 mm Hg. An electronic tip sensor or a pressure capillary tube placed at the distal end of the lumen of the rinsing channel of the endoscope did not interfere with rinsing flow and produced measurements that were equal to ventricular pressures.

Anaesthetic Management of Patients Undergoing Intraventricular Neuro-Endoscopic Procedures

“…Since fluids flow down pressure gradients, and flowing fluids generate dynamic resistances, measurement at the rinsing inlet and outlet may at higher rinsing speeds correlate poorly with ventricular measurements. An Invitro study comparing "ventricular" pressure with pressure at the rinsing inlet and outlet shows very significant respective over-and underestimations of the true "intracranial pressure" of up to 50mmHg at high rinsing flows (Dewaele et al, 2011). Measurement via a capillary tube or electronic tip sensor advanced through the rinsing inlet channel of the endoscope provides reliable ICP measurements and may -based on these in vitro observations -be proposed as best practice.…”

Microsurgery with or without neuroendoscopy in 24 petroclival meningiomas

“…Skull base surgery is also being developed as a minimally invasive procedure. At present, numerous studies have been conducted on skull base neuroendoscopy of hypophysomas, chordomas, and saddle area anatomy (2,3,6,8,9). Based on the minimally invasive skull base approach, neuroendoscopy was included in petroclival meningioma operations in this study.…”