gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

The clinical value of neuronavigation in surgery for intracranial cavernomas

Die klinische Bedeutung der Neuronavigation bei der chirurgischen Behandlung von intrakraniellen Kavernomen

Meeting Abstract

  • corresponding author T. Mikami - Klinik für Neurochirurgie, Philipps-Universität Marburg
  • H. Bertalanffy - Klinik für Neurochirurgie, Philipps-Universität Marburg
  • W. Tirakotai - Klinik für Neurochirurgie, Philipps-Universität Marburg
  • T. Dukatz - Klinik für Neurochirurgie, Philipps-Universität Marburg
  • L. Benes - Klinik für Neurochirurgie, Philipps-Universität Marburg
  • U. Sure - Klinik für Neurochirurgie, Philipps-Universität Marburg

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSA.06.08

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc173.shtml

Veröffentlicht: 11. April 2007

© 2007 Mikami et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: In this study the authors review their experience with navigation-assisted surgery of intracranial cavernomas in order to define a possible benefit of neuronavigation for cavernoma surgery.

Methods: Between January 1997 and August 2006, 173 patients with 180 intracranial cavernomas underwent operation with the assistance of a neuronavigation system (BrainLab AG, Munich, Germany). The mean size of the cavernomas was 14.6 mm. The neuronavigation system was used to place the skin incision, localize the craniotomy, determine the nearest sulcus, establish the optimal trajectory, establish the entry point and ascertain anatomical orientation. The authors review the value of navigation in each case, and define its usefulenss in cavernoma surgery.

Results: The neuronavigation system worked properly in 99.5% of the patients. From the aspect of utility, the lesions can be categorized into 4 types. Type I; In cortical and subcortical lesions, the navigation assisstance was very valuable for placement of the skin incision and localization of the craniotomy. Type II; In medial temporal, ventricular and periventricular cavernomas, the usefulness of navigation was high, especially in the establishment of the optimal trajectory. Type III; In cerebellum, brachium pontis, midbrain tectum, thalamus, insular region and basal ganglia, navigation was valuable mainly in the localization of the craniotomy, establishment of the optimal trajectory and establishment of the entry point. Type IV; In the lesions of lateral medulla, lateral pons, midbrain peduncle, lateral midbrain and rhomboid fossa, the navigation system was useful for the establishment of the optimal trajectory and the entry point.

Conclusions: Neuronavigation assistance during surgery for cavernomas facilitates the precise identification of the lesion and trajectory line. Accordingly, safe exposure can be obtained by minimal traumatization of normal structures. This retrospective study indicates that the application of neuronavigation allows better cavernoma surgery with methods tailored to suit individual patients.