Application of neuronavigation and endoscopy in the treatment of chronic subdural hematoma

Abstract

Objective To explore the effect of neuronavigation and endoscopy in the operation of chronic subdural hematoma. Methods One hundred and sixteen patients with subdural hematoma admitted to Shenzhen People’s Hospital from June 2014 to June 2018 were divided into routine operation group and neuronavigation endoscopy assistant group according to the application of surgical equipment. One week after the operation, the patients in the two treatment groups underwent CT reexamination to compare the recurrence of hematoma, residual hematoma and intracranial pneumatosis. One month after operation, CT was performed to compare the recurrence and residual of hematoma. Results One week after operation, the patients underwent CT reexamination. In the routine operation group, 19 cases had partial hematoma residue and 45 cases had hematoma disappearance. In the neuronavigation endoscopy-assisted group, 7 cases of partial hematoma remained and 45 cases of hematoma disappeared. The difference was significant (P=0.037). In the conventional operation group, there were 6 cases of subdural effusion and pneumocele, and 58 cases of no effusion and pneumocele. In neuronavigation endoscopy-assisted group, 4 cases had subdural effusion and pneumocele, 48 cases had no effusion and pneumocele. There was no significant difference (P=0.748). One month after operation, the patients underwent CT reexamination. In the routine operation group, 11 cases had hematoma residual or recurrence, and 53 cases had hematoma disappearance. In the neuronavigation endoscopy-assisted group, there were 3 cases of hematoma residual or recurrence, and 49 cases of hematoma disappeared. The difference was significant (P=0.038). Conclusion The application of neuronavigation and endoscopy-assisted drilling and drainage for chronic subdural hematoma may improve the complete clearance rate of hematoma and reduce the recurrence rate of long-term hematoma, which has certain application value. Key words: Chronic subdural hematoma; Neuronavigation; Neuroendoscopy