Articles: neuronavigation.
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Jugular foramen tumors are rare and challenging lesions for skull base surgeons because of their difficult operative accessibility. Various surgical approaches to the jugular foramen have been described to overcome the morbidity of standard petrosectomy. ⋯ The navigation-guided presigmoidal suprabulbar infralabyrinthine approach is a minimally invasive approach for selected lesions of the jugular foramen with preservation of the fallopian canal, labyrinthine block, and sigmoid sinus. This approach is suited for C1, De1, De2, Di1, and Di2 tumors according to the Fisch classification.
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Parallel advancements in image guidance technology and minimal access techniques continue to push the frontiers of minimally invasive spine surgery (MISS). While traditional intraoperative imaging remains widely used, newer platforms, such as 3D-fluoroscopy, cone-beam CT, and intraoperative CT/MRI, have enabled safer, more accurate instrumentation placement with less radiation exposure to the surgeon. The goal of this work is to provide a review of the current uses of advanced image guidance in MISS. ⋯ Refinements in image-guidance technologies and minimal access techniques have converged on spinal pathology, affording patients the ability to undergo safe, accurate operations without the associated morbidities of conventional approaches. While percutaneous transpedicular screw placement is among the most common procedures to benefit from navigation, other areas of spine surgery can benefit from advances in neuronavigation and further growth in the field of image-guided MISS is anticipated.
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Clin Neurol Neurosurg · Aug 2013
Case ReportsImage guidance to improve reliability and data integrity of transcranial Doppler sonography.
Principles and accuracy of image-guided transcranial Doppler (IG TCD) sonography have been published recently. However, it remains open whether combination of image guidance and TCD offers an additional clinical advantage. This study scores the accuracy of conventional TCD examinations and investigates the potential improvement of TCD data integrity and reliability regarding the additional use of IG. ⋯ Our data suggest, that misinterpretation of the vascular source of the Doppler signal is a common source of errors in conventional TCD. Visualization of the vascular anatomy by image guidance offers improved accuracy and reliability of TCD results and may positively influence the learning curve for inexperienced investigators.
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Case Reports
Neuronavigation-guided intubated wake-up craniotomy for a patient with a brain astrocytoma.
Computer-assisted neuronavigation (an image-guided technique that facilitates brain tumor surgery) reduces the risk of neurological morbidity. Postoperative neurological dysfunction is also minimized by performing intraoperative neurological testing during awake craniotomy with proper surgical resection of a brain tumor. ⋯ The patient was intubated throughout the course of the procedure, during which modified intraoperative neurological tests were performed for cortical mapping. The patient recovered well after the operation and without any neurological deficits.
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Journal of neurosurgery · Jul 2013
Comparative StudyComparison of the accuracy of ventricular catheter placement using freehand placement, ultrasonic guidance, and stereotactic neuronavigation.
The objective of this study was to compare the accuracy of 3 methods of ventricular catheter placement during CSF shunt operations: the freehand technique using surface anatomy, ultrasonic guidance, and stereotactic neuronavigation. ⋯ Stereotactic- and ultrasound-guided ventricular catheter placements are significantly more accurate than freehand placement, and the use of these intraoperative guidance techniques reduced proximal shunt failure in this study.