The use of the sodium fluorescein and YELLOW 560 nm filter for the resection of pediatric posterior fossa lesions

Childs Nerv Syst. 2023 Jun;39(6):1495-1500. doi: 10.1007/s00381-022-05798-9. Epub 2022 Dec 17.

Abstract

Purpose: This study aimed to verify the feasibility, safety, and benefit of using fluorescein sodium (FL) and a YELLOW 560 nm filter in posterior fossa tumors in children.

Methods: All cases of pediatric posterior fossa tumors that have undergone surgery using fluorescein (2018-2022) have been included and were examined retrospectively. In those cases where resection of the tumor was planned, a blinded neuroradiologist distinguished gross total resection and subtotal resection according to the postoperative MRI findings. The surgical report and medical files were reviewed regarding the intraoperative staining grade and adverse events. The grade of fluorescent staining of the targeted lesion was assessed as described in the surgical reports. The screening was conducted for any reference to the degree of fluorescent staining: "intense," "medium," "slight," and "no staining."

Results: 19 cases have been included. In 14 cases, a complete resection was initially intended. In 11 of these cases, a gross total resection could be achieved (78.6%). Staining was described as intense in most cases (58.8%). Except for yellow-colored urine, no side effects obviously related to FL were found throughout the observation period.

Conclusion: In combination with a specific filter, FL is a reliable, safe, and feasible tool in posterior fossa surgery in children.

Keywords: Child; Fluorescein; Neurosurgery; Posterior Fossa.

MeSH terms

  • Brain Neoplasms* / surgery
  • Child
  • Fluorescein
  • Fluorescent Dyes
  • Humans
  • Infratentorial Neoplasms* / diagnostic imaging
  • Infratentorial Neoplasms* / surgery
  • Neurosurgical Procedures / adverse effects
  • Retrospective Studies

Substances

  • Fluorescein
  • Fluorescent Dyes