Intraoperative Fluorescein Sodium in Pediatric Neurosurgery: A Preliminary Case Series from a Singapore Children’s Hospital
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Patient Selection
2.2. Outline of Operative Procedure and Perioperative Management
2.3. Patient Demographics, Radiological Features, and Variables of Interest
3. Results
3.1. Overview of Study Population and Its Characteristics
3.2. Evaluation of Na-Fl as an Intraoperative Adjunct
3.3. Illustrative Cases of Interest: Radiation-Induced Gliomas
4. Discussion
4.1. Surgery for Pediatric Brain Tumors: Technical Challenges
4.2. Fluorescent Dyes for Brain Tumor Surgery: An Overview
4.3. Use of Intraoperative Na-Fl: Institutional Reflections
4.4. Study Critique and Future Directions
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Parameter | Value (%) |
---|---|
Total number of patients | 21 (100) |
Age (years) | 12.1 ± 5.3 (mean ± SD) |
Gender | |
Male | 13 (61.9) |
Female | 8 (38.1) |
Type of surgery | |
Biopsy | 6 (28.6) |
Resection | 15 (71.4) |
Histopathological diagnosis 1 | |
Non-neoplastic lesion (cavernoma) | 1 (4.8) |
Neoplastic lesions | 20 (95.2) |
Low grade glioma | 6 (28.6) |
Hemispheric high grade glioma | 6 (28.6) |
Medulloblastoma | 2 (9.5) |
Diffuse midline glioma (H3K27M-altered)—1 thalamus and 2 brainstem | 3 (14.3) |
Craniopharyngioma | 1 (4.8) |
Choroid plexus carcinoma | 1 (4.8) |
Primary intracranial malignant melanoma | 1 (4.8) |
Adverse side effects from Na-Fl | |
Yes | 0 (0) |
No | 21 (100) |
Score for Na-Fl fluorescence | |
0 | 3 (14.3) |
1 | 0 (0) |
2 | 5 (23.8) |
3 | 13 (61.9) |
Concurrent operative adjuncts | |
DTI imaging | 13 (61.9) |
iMRI operating theatre | 1 (4.8) |
IONM | 3 (14.3) |
Transtubular system | 3 (14.3) |
NIL | 6 (28.6) |
Location of lesion | |
Suprasellar | 2 (9.5) |
Frontal | 2 (9.5) |
Temporal | 1 (4.8) |
Parietal | 4 (19.1) |
Occipital | 1 (4.8) |
Thalamic | 4 (19.1) |
Intraventricular (frontal horn) | 1 (4.8) |
Posterior fossa | 4 (19.1) |
Brainstem | 2 (9.5) |
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Tan, A.J.L.; Tey, M.L.; Seow, W.T.; Low, D.C.Y.; Chang, K.T.E.; Ng, L.P.; Looi, W.S.; Wong, R.X.; Tan, E.E.K.; Low, S.Y.Y. Intraoperative Fluorescein Sodium in Pediatric Neurosurgery: A Preliminary Case Series from a Singapore Children’s Hospital. NeuroSci 2023, 4, 54-64. https://doi.org/10.3390/neurosci4010007
Tan AJL, Tey ML, Seow WT, Low DCY, Chang KTE, Ng LP, Looi WS, Wong RX, Tan EEK, Low SYY. Intraoperative Fluorescein Sodium in Pediatric Neurosurgery: A Preliminary Case Series from a Singapore Children’s Hospital. NeuroSci. 2023; 4(1):54-64. https://doi.org/10.3390/neurosci4010007
Chicago/Turabian StyleTan, Audrey J. L., Min Li Tey, Wan Tew Seow, David C. Y. Low, Kenneth T. E. Chang, Lee Ping Ng, Wen Shen Looi, Ru Xin Wong, Enrica E. K. Tan, and Sharon Y. Y. Low. 2023. "Intraoperative Fluorescein Sodium in Pediatric Neurosurgery: A Preliminary Case Series from a Singapore Children’s Hospital" NeuroSci 4, no. 1: 54-64. https://doi.org/10.3390/neurosci4010007