Articles: neuronavigation.
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To evaluate a new technique in brainstem surgery, neuronavigation (NN)-guided corticospinal tract (CST) mapping, in a retrospective study of patients undergoing brainstem tumor surgery. ⋯ Brainstem tumor resection using NN-guided CST mapping achieved better preservation of motor function compared with routine NN and IONM. NN-guided CST mapping not only decreased the difficulty of the surgery, but also significantly improved the efficiency of surgery.
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Image guidance based on magnetic resonance imaging (MRI) and/or ultrasound (US) is widely used to aid decision making in glioma surgery, but tumor delineation based on these 2 modalities does not always correspond. ⋯ The tumor volumes of LGGs segmented from intraoperative US images were most often smaller than the tumor volumes segmented from preoperative MRIs. There was a much better match between the 2 modalities in astrocytomas.
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Recently, the neuronavigation system (NS) has become an essential intraoperative tool for many neurosurgical procedures, allowing for precise lesion localization. It is particularly important to avoid errors during the navigation process. Here we report a novel technique using palatal positioning of the patient tracker to ensure optimal accuracy during magnetic navigation in various neurosurgical procedures. ⋯ The positioning of the patient tracker under the hard palate proved safe, accurate, and feasible in 97% of our patients. In our case series, it met the main goal of avoiding device displacement without a sense of invasiveness and postoperative patient discomfort.
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Numerous studies have demonstrated the importance of gross total resection in improving patient survival in glioblastoma (GBM). Advances in surgical tools and techniques such as intra-operative imaging, fluorescent agents, and functional imaging sequences are allowing for better identification of tumor borders and vital eloquent cortex in order to safely achieve higher rates of complete resections. Furthermore, due to the limits of surgical resection alone, new minimally invasive techniques for treatment of GBM are under development. These advances are crucial for improving neurosurgical care and outcomes in this difficult patient population.
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Cadaveric laboratory study. ⋯ N/A.