دورية أكاديمية
The use of intraoperative neurosurgical ultrasound for surgical navigation in low- and middle-income countries: the initial experience in Tanzania.
| العنوان: | The use of intraoperative neurosurgical ultrasound for surgical navigation in low- and middle-income countries: the initial experience in Tanzania. |
|---|---|
| المؤلفون: | Kaale AJ; 1Division of Neurosurgery, Muhimbili Orthopaedic and Neurosurgical Institute, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; and., Rutabasibwa N; 1Division of Neurosurgery, Muhimbili Orthopaedic and Neurosurgical Institute, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; and., Mchome LL; 1Division of Neurosurgery, Muhimbili Orthopaedic and Neurosurgical Institute, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; and., Lillehei KO; Departments of2Neurosurgery and., Honce JM; 3Radiology, University of Colorado School of Medicine, Aurora, Colorado., Kahamba J; 1Division of Neurosurgery, Muhimbili Orthopaedic and Neurosurgical Institute, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; and., Ormond DR; Departments of2Neurosurgery and. |
| المصدر: | Journal of neurosurgery [J Neurosurg] 2020 Feb 28; Vol. 134 (2), pp. 630-637. Date of Electronic Publication: 2020 Feb 28. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Association of Neurological Surgeons Country of Publication: United States NLM ID: 0253357 Publication Model: Electronic Cited Medium: Internet ISSN: 1933-0693 (Electronic) Linking ISSN: 00223085 NLM ISO Abbreviation: J Neurosurg Subsets: PubMed not MEDLINE; MEDLINE |
| أسماء مطبوعة: | Publication: Charlottesville, VA : American Association of Neurological Surgeons Original Publication: Chicago [etc.] |
| مستخلص: | Objective: Neuronavigation has become a crucial tool in the surgical management of CNS pathology in higher-income countries, but has yet to be implemented in most low- and middle-income countries (LMICs) due to cost constraints. In these resource-limited settings, neurosurgeons typically rely on their understanding of neuroanatomy and preoperative imaging to help guide them through a particular operation, making surgery more challenging for the surgeon and a higher risk for the patient. Alternatives to assist the surgeon improve the safety and efficacy of neurosurgery are important for the expansion of subspecialty neurosurgery in LMICs. A low-cost and efficacious alternative may be the use of intraoperative neurosurgical ultrasound. The authors analyze the preliminary results of the introduction of intraoperative ultrasound in an LMIC setting. Methods: After a training program in intraoperative ultrasound including courses conducted in Dar es Salaam, Tanzania, and Aurora, Colorado, neurosurgeons at the Muhimbili Orthopaedic and Neurosurgical Institute began its independent use. The initial experience is reported from the first 24 prospective cases in which intraoperative ultrasound was used. When possible, ultrasound findings were recorded and compared with postoperative imaging findings in order to establish accuracy of intraoperative interpretation. Results: Of 24 cases of intraoperative ultrasound that were reported, 29.2% were spine surgeries and 70.8% were cranial. The majority were tumor cases (95.8%). Lesions were identified through the dura mater in all 24 cases, with 20.8% requiring extension of craniotomy or laminectomy due to inadequate exposure. Postoperative imaging (typically CT) was only performed in 11 cases, but all 11 matched the findings on post-dural closure ultrasound. Conclusions: The use of intraoperative ultrasound, which is affordable and available locally, is changing neurosurgical care in Tanzania. Ultimately, expanding the use of intraoperative B-mode ultrasound in Tanzania and other LMICs may help improve neurosurgical care in these countries in an affordable manner. |
| فهرسة مساهمة: | Keywords: Tanzania; intraoperative ultrasound; low- and middle-income countries; neuronavigation; surgical technique |
| تواريخ الأحداث: | Date Created: 20200229 Latest Revision: 20240521 |
| رمز التحديث: | 20240521 |
| DOI: | 10.3171/2019.12.JNS192851 |
| PMID: | 32109864 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1933-0693 |
|---|---|
| DOI: | 10.3171/2019.12.JNS192851 |