Ommaya Reservoir Placement
An Ommaya reservoir is a synthetic dome that is surgically placed beneath the scalp and attached to a catheter that is inserted within the brain. The catheter is directed into a ventricle, which is an open space in the brain where cerebrospinal fluid flows. Cerebrospinal fluid travels around the brain and spinal cord. The purpose of the Ommaya reservoir is to collect samples of cerebrospinal fluid that can then be tested for the presence of infection or cancerous cells and to administer medication such as antibiotics or chemotherapy drugs directly into the cerebrospinal fluid.
The Ommaya reservoir can be a particularly effective method of treatment for certain types of brain cancer. It delivers the chemotherapy directly to the cerebrospinal fluid to attack the malignant cells in the area. This enables the medication to bypass the blood-brain barrier-a system of blood vessels that surround the brain in order to keep foreign substances from penetrating brain tissue. Due to the efficiency of the blood-brain barrier, it has traditionally been very difficult to successfully administer chemotherapy to fully treat some forms of brain cancer.
The Ommaya Reservoir Placement Procedure
This procedure is performed with the patient under general anesthesia. The patient’s head is properly positioned, then a small area of the scalp is shaved. Dr. Lipani will make a small, rounded incision and insert the Ommaya reservoir securely between the skull bones and the scalp. The catheter is carefully guided through the head until it reaches a ventricle in the brain. Once the reservoir and catheter have been correctly placed, the surgeon will close the scalp incision using sutures or staples. The placement procedure typically lasts for one hour.
Recovery from Ommaya Reservoir Placement
A procedure for the placement of an Ommaya reservoir generally requires a hospital stay of one night to ensure that the catheter is correctly positioned and that the incision is beginning to heal well. The sutures or staples in the scalp are removed approximately 10 to 14 days after the surgery. A small bump will remain at the treatment site, but normal activities can be resumed as soon as the incision is completed healed.
Risks of Ommaya Reservoir Placement
An Ommaya reservoir placement is a surgical procedure, and all surgeries carry some form of risk. The complications that are associated with this procedure include bleeding, infection or, very rarely, neurological impairment. In certain cases, the reservoir may not be readily collecting fluid. If a placement problem is suspected, an MRI scan will be performed to obtain a clear view of the Ommaya reservoir. If the reservoir or catheter is found to be out of place, a follow-up procedure may be necessary to reposition it.
Ommaya Reservoir Treatments
When treatment is needed, an antibacterial cleanser will be applied to the skin. Dr. Lipani will insert a small needle into the Ommaya reservoir. At that point, fluid may be withdrawn or medication may be administered. As soon as the process is completed, the needle is removed and the site is covered with a bandage. The Ommaya reservoir is pumped several times with light pressure to move the cerebrospinal fluid or medication along the catheter tubing.
Side effects are common after an Ommaya reservoir treatment. Patients may experience pain upon insertion of the needle, or headaches, nausea or vomiting afterward. Allowing the patient to lie down for a rest period following a treatment session can be helpful. Once any side effects subside, the patient is free to participate in all normal activities.