Acta clinica Croatica, Vol. 59. No. 1., 2020.
Other
https://doi.org/10.20471/acc.2020.59.01.23
Minimally Invasive Treatment of Idiopathic Syringomyelia Using Myringotomy T-Tubes: a Case Report and Technical Note
Domagoj Jugović
; Department of Neurosurgery, Bamberg General Hospital, Bamberg, Germany; University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
Roman Bošnjak
; University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia; Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana, Slovenia
Krešimir Rotim
; Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; University of Applied Health Sciences, Zagreb, Croatia
Günther C. Feigl
; Department of Neurosurgery, Bamberg General Hospital, Bamberg, Germany; Department of Neurosurgery, Tübingen University Hospital, Tübingen, Germany; Department of Neurological Surgery, Houston Methodist Hospital, Houston, Texas, USA
Abstract
Syringomyelia is characterized by a fluid-filled cavity within the spinal cord. Expansion of the syrinx often results in the clinical course of progressive neurologic deficit. Surgery for syringomyelia generally aims to treat the underlying cause, if it is known. However, little is known
about idiopathic syringomyelia, which requires specific management. In our paper, an alternative, minimally invasive treatment option for large symptomatic idiopathic cervicothoracic syrinx is described and discussed. We present a case of a 44-year-old male without a history of spinal cord trauma, infection, or other pathologic processes, who presented for thoracic pain. Due to progressive pain and left leg paresis, magnetic resonance imaging (MRI) was performed and revealed extensive septated syringomyelia from T5 to T7 and hydromyelia cranially. We applied minimally invasive technique for shunting the idiopathic syrinx into the subarachnoid space using two Richards modified myringotomy T-tubes. Postoperative MRI revealed significant decrease in the syrinx size and clinical six-month follow-up showed improvement of clinical symptoms. This minimally invasive treatment of
syringomyelia was found to be an effective method for idiopathic septated syrinx, without evident underlying cause. However, long-term follow-up and more patients are necessary for definitive evaluation of this technique.
Keywords
Syringomyelia; Magnetic resonance imaging; Cerebrospinal fluid shunts; Middle ear ventilation
Hrčak ID:
242448
URI
Publication date:
1.3.2020.
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