Brain, Vol. 122, No. 8, 1602,
August 1999
© 1999 Oxford University Press
Book Reviews |
ENDOSCOPY OF THE CENTRAL AND PERIPHERAL NERVOUS SYSTEM.
By Wesley King, John Frazee and Antonio de Salles.1998. Pp. 250. New York: Trias.Price DM 368. ISBN 3-13-103611-7..
University Hospital of Wales, Cardiff, UK
Although endoscopy within the CNS was first attempted at the beginning of the century, it has only recently been widely advocated. Endoscopy in other medical and surgical fields is now firmly established but the process of defining its uses in the central and peripheral nervous system is still in its infancy. Only within the ventricular system has the technique become firmly established in the treatment of hydrocephalus and intraventricular tumours.
In the last decade many advances have been made in equipment and procedures for using endoscopic techniques within the ventricles, at the skull base, within the parenchyma in the spine and around the peripheral nerves. This 250-page multi-author publication gives a concise overview of the techniques and instrumentation used by some of the world's most enthusiastic neuro-endoscopists.
The first chapter gives an interesting historical review of the concepts and instruments from Bozzini's description of the first endoscope in 1806 using candlelight, to modern flexible fibre-optic systems with three chip video cameras. The historical introduction is followed by descriptions of the various aspects of instrumentation and techniques that are currently used in neuroendoscopy, including stereotactic and image guided neuroendoscopy.
By far the most widely accepted use for neuroendoscopy is the management of hydrocephalus and intraventricular lesions and a chapter is appropriately devoted to the endoscopic anatomy of the ventricular system. The endoscopic management of hydrocephalus and intraventricular lesions is fully covered with a further chapter on management of colloid cysts comparing microsurgical with endoscopic techniques. Clearly the authors are enthusiastic endoscopists but their assertion that a review of their results indicates a statistically significant advantage to endoscopy must be put in context. Colloid cysts are relatively uncommon; they quote a non-randomized series of eight patients undergoing microsurgical removal versus 19 in the endoscopy group, which would seem a rather small series upon which to make such assertions. However, they clearly demonstrate the feasibility of this type of surgery with impressive results.
Whereas endoscopy of the ventricular system is firmly established, other applications within the CNS have progressed more slowly. Chapter 10 gives a detailed overview of the endoscopy of intra-axial lesions from cystic tumours to intracerebral haematomas. Such uses are more controversial and the pros and cons of the technique are discussed in detail. Endoscopically assisted micro-neurosurgery is another expanding field which is fully discussed, as is the management of arachnoid cysts.
Major sections are devoted to endoscopic treatment of thoracic and lumbar spine disorders. Development of instrumentation has been particularly impressive in these fields allowing the most complex spinal surgery to be performed endoscopically. These techniques and instruments are fully described, although they need further evaluation. Endoscopy of the paranasal sinuses, the sympathetic nervous system and even the carpal tunnel are also covered.
Although the quality of a few of the scans and photographs is poor, the general quality of the photographs is excellent and many of the accompanying illustrations are also extremely good. This publication gives an excellent overview of the field of neuroendoscopy from endoscopic carpal tunnel decompressions to the use of telepresence neuroendoscopy, and I can recommend it to anyone with an interest in the field.
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||