title: Indocyanine green fluorescence endoscopy at endonasal transsphenoidal surgery for an intracavernous sinus dermoid cyst: case report.
abstract: The complete resection of intracavernous sinus dermoid cysts is very difficult due to tumor tissue adherence to important anatomical structures such as the internal carotid artery (ICA), cavernous sinus, and cranial nerves. As residual dermoid cyst tissue sometimes induces symptoms and repeat surgery may be required after cyst recurrence, minimal invasiveness is an important consideration when selecting the surgical approach to the lesion. We addressed a recurrent intracavernous sinus dermoid cyst by the endoscopic endonasal transsphenoidal approach assisted by neuronavigation and indocyanine green (ICG) endoscopy to confirm the ICA and patency of the cavernous sinus. The ICG endoscope detected the fluorescence signal from the ICA and cavernous sinus; its intensity changed with the passage of time. The ICG endoscope was very useful for real-time imaging, and its high spatial resolution facilitated the detection of the ICA and the patent cavernous sinus. We found it to be of great value for successful endonasal transsphenoidal surgery.
authors.affiliation: Department of Neurosurgery, Kumamoto University Graduate School of Medical Science.
authors.forename: Takuichiro
authors.initials: T
authors.lastname: Hide
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Yano
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Kuratsu
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D002426:Cavernous Sinus / Q000473:pathology / Q000601:surgery*; D003884:Dermoid Cyst / Q000473:pathology / Q000601:surgery*; D004867:Equipment Design; D005456:Fluorescent Dyes; D006801:Humans; D007208:Indocyanine Green; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D018365:Neoplasm, Residual / Q000473:pathology / Q000601:surgery*; D044583:Neuroendoscopy / Q000295:instrumentation* / Q000379:methods*; D038361:Neuronavigation / Q000295:instrumentation* / Q000379:methods*; D012086:Reoperation; D013101:Sphenoid Sinus / Q000473:pathology / Q000601:surgery; D013525:Surgical Instruments; D014057:Tomography, X-Ray Computed
chemical_list: D005456:Fluorescent Dyes; D007208:Indocyanine Green