gms | German Medical Science

66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

Accuracy of neuronavigation in the posterior fossa

Meeting Abstract

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  • Axel Neulen - Klinik für Neurochirurgie, Universitätsmedizin Mainz
  • Maximilian Stein - Klinik für Neurochirurgie, Universitätsmedizin Mainz
  • Alf Giese - Klinik für Neurochirurgie, Universitätsmedizin Mainz

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocP 132

doi: 10.3205/15dgnc530, urn:nbn:de:0183-15dgnc5304

Published: June 2, 2015

© 2015 Neulen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: While intraoperative neuronavigation is believed to be highly precise for supratentorial approaches, its accuracy in the posterior fossa, where neuronavigation could be of advantage in special cases, is thought to be less. The aim of the present study was therefore to assess the accuracy of neuronavigation in the posterior fossa.

Method: A navigation plan with 8 supratentorial and 3 infratentorial vascular target points was prepared using CTA data sets of SAH patients. After non-invasive registration of the head, a 2MHz Doppler probe (DWL) was tracked by a Kolibri image-guidance device (Brainlab AG). The probe was directed to the pre-defined target points using the IG device. Then the probe was moved to the point of the optimal Doppler signal where a new trajectory was acquired. This new trajectory was used as reference in all subsequent examinations. The distance between reference point and point of optimal Doppler signal was calculated to quantify the accuracy of IG.

Results: 50 examinations were performed in 10 patients yielding 315 supratentorial and 120 infratentorial trajectories. The mean deviation of the supratentorial trajectories was significantly lower compared to the posterior fossa (3.3 ± 1.7 mm vs. 5.4 ± 2.8 mm). For the vertebral arteries the deviation was significantly lower compared to the basilar artery (4.6 ± 1.9 mm vs. 6.9 ± 3.5 mm).

Conclusions: Neuronavigation provides a higher accuracy for supratentorial targets than for infratentorial target points. For deep infratentorial vessels, the inaccuracy of navigation increases.