Usefulness of Pulsed Water Jet in Dissecting Sphenoid Ridge Meningioma while Preserving Arteries Toshiki ENDO 1 , Atsuhiro NAKAGAWA 1 , Miki FUJIMURA 1 , Yukihiko SONODA 1 , Hiroaki SHIMIZU 1 , Teiji TOMINAGA 1 1Department of Neurosurgery, Tohoku University Graduate School of Medicine Keyword: internal carotid artery , meningioma , water pulsed jet pp.1019-1025
Published Date 2014/11/10
DOI https://doi.org/10.11477/mf.1436200025
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 We report the utility of a pulsed water jet device in meningioma surgery. The presented case is that of a 61-year-old woman with left visual disturbance. MRI demonstrated heterogeneously enhanced mass with intratumoral hemorrhage, indicating sphenoid ridge meningioma on her left side. The tumor invaded the cavernous sinus and left optic canal, engulfing the internal carotid artery in the carotid cistern and encased middle cerebral arteries. During the operation, the pulsed water jet device was useful for dissecting the tumor away from the arteries since it was safe in light of preserving parent arteries. The jet did not cause any vascular injury and did not induce vasospasm as shown by postoperative symptomatology and MRIs. With the aid of pulsed water jet, we could achieve total resection of the tumor except for the piece within the cavernous sinus. The patient had no new neurological deficits after the operation.

 We consider the pulsed water jet as a useful device, especially when the need to dissect meningioma from parent arteries exists. The jet can help neurosurgeons simultaneously achieve tumor resection and preservation of blood vessels.

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