Using the Nasopharyngeal Airway as a Transparent Sheath for Endoscopic Evacuation of Hematoma Induced by Hemorrhagic Stroke

Abstract

Background and Purpose: Minimally invasive endoscopic removal of hematoma induced by hemorrhagic stroke is a modern technique in neurosurgery. However, this surgical technique is still believed to be difficult due to lack of a proper transparent material served as a working channel. A transparent sheath designed for intracranial endoscopic surgery is an important assistant equipment. However, the cost of the sheath is too expensive to be used in ordinary brain surgery. Therefore, here we adjust the nasopharyngeal airway, which is less expensive, to be the transparent sheath. Methods: Since 2005, we had tried to perform endoscopic evacuation for the hematoma induced by hemorrhagic stroke. The nasopharyngeal airway was used as the transparent sheath in each case. Under the help of one rigid straight 0-degree endoscope, the hematoma was removed by the sucker piece by piece. If any bleeding happened, it could be controlled by monopolar coagulator which is located on the tip of sucker. Results: There were 7 male and 5 female patients who accepted this procedure. The mean age was 56.1 years (range 38 to 78 years). Up to eighty percent of hematoma was successfully evacuated by this endoscopic surgery in all patients. We used Glasgow outcome scale to evaluate postoperative outcome. Nine patients (75%) returned to clear conscious state. No mortality was found during our follow-up for at least 3 months. But the long-term results should be closely observed. Conclusion: These preliminary results revealed that the nasopharyngeal airway is an effective and safe transparent sheath for endoscopic evacuation of intracerebral hematomas. Because of its less expensive and easily available character, the nasopharyngeal airway has the great potential benefit to become the useful transparent sheath in neuroendoscopic surgery.