Catheter placement for Ommaya reservoirs with frameless surgical navigation: technical note.
OBJECTIVE
Infusion of intraventricular chemotherapy requires precise ventricular catheter placement in oncology patients to avoid intraparenchymal infusion. We assessed the safety and precision of using frameless surgical navigation for the placement of Ommaya reservoir catheters.


METHODS
In 20 consecutive patients who required Ommaya reservoirs for the administration of intrathecal chemotherapy, the catheters were positioned with the guidance of frameless stereotaxy. Precision of catheter placement, operative time, operative complications, and postoperative complications were assessed.


RESULTS
All catheters were completely within cerebrospinal fluid and 90% were within 5 mm of the intended target, the ipsilateral foramen of Monro. The average operative time was 47 min, and there were no intraoperative complications. There were no reports of leukoencephalopathy, and 3 patients had minor delayed complications.


CONCLUSIONS
Frameless surgical navigation is a useful and efficient method for ensuring accurate catheter placement during Ommaya reservoir implantation, and it reduces the risk of potential parenchymal toxicity.
Greenfield
Jeffrey P
JP
Department of Neurological Surgery, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY 10021, USA.
Schwartz
Theodore H
TH
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002404:Catheterization / Q000295:instrumentation / Q000379:methods; D002408:Catheters, Indwelling; D016543:Central Nervous System Neoplasms / Q000188:drug therapy; D016503:Drug Delivery Systems / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*
D000970:Antineoplastic Agents