Minim Invasive Neurosurg 2007; 50(6): 340-345
DOI: 10.1055/s-2007-993162
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Navigation-Guided Ommaya Reservoir Placement: Implications for the Treatment of Leptomeningeal Metastases

M. Takahashi 1 , R. Yamada 1 , Y. Tabei 1 , O. Nakamura 1 , N. Shinoura 1
  • 1Department of Neurosurgery, Komagome Metropolitan Hospital, Bunkyo-ku, Tokyo, Japan
Further Information

Publication History

Publication Date:
22 January 2008 (online)

Preview

Abstract

Ommaya reservoirs are commonly used in the diagnosis and management of leptomeningeal metastases (LM) from malignant tumors. The present study investigates the utility of an intraoperative navigation-guided technique for Ommaya reservoir placement. Between March 2004 and December 2005, 85 navigation-guided Ommaya reservoir placements were performed in 77 patients with intracranial malignancies at the Komagome Metropolitan Hospital. Anterior horn puncture and posterior horn puncture were used for 59 and 26 procedures, respectively. A slit ventricle was present in 6 cases. All procedures were performed under assistance from the Medtronic STEALTH STATION TRIA navigation system. Computed tomographic (CT) scans were routinely obtained just after completion of the procedure. Patients diagnosed with LM received subsequent treatment. An Ommaya catheter was applied to the ventricular puncture needle registered in the navigation system and was inserted into the lateral ventricle. Using the real-time “Guidance View”, the surgeon was able to verify the catheter position continuously during the procedure. Postoperative CT scan revealed an appropriate catheter position in all except for one case. Complications (catheter malposition) occurred in only one case (complication rate, 1.2%). None of the patients experienced hemorrhage or infection. In conclusion, navigation-guided Ommaya reservoir placement was associated with a very low incidence of complications. This method appears to be safe and effective when employed in patients with intracranial malignancy.

References

Correspondence

N. Shinoura

Department of Neurosurgery

Komagome Metropolitan Hospital

3-18-22 Hon-Komagome

Bunkyo-ku

Tokyo 113-8677

Japan

Phone: +81/3/3823 21 01

Fax: +81/3/3824 15 52

Email: shinoura@cick.jp