Department of Neurosurgery, Unye State Hospital, Ordu, Turkey.
Department of Neurosurgery, Kahramanmaras Necip Fazıl City Hospital, Kahramanmaras, Turkey.
Med Sci Monit. 2024 Jul 11;30:e944724. doi: 10.12659/MSM.944724.
BACKGROUND The BrainLab VectorVision neuronavigation system is an image-guided, frameless localization system used intraoperatively, which includes a computer workstation for viewing and analyzing operative microscopic images. This retrospective study aimed to evaluate the use of the BrainLab VectorVision infrared-based neuronavigation imaging system in 80 patients with intracranial meningioma removed surgically between 2013 and 2023. MATERIAL AND METHODS Data were retrospectively collected from 36 patients with convexity meningioma and 44 patients with parasagittal meningioma between 2013 and 2023. The surgical operation of 40 of these patients was performed with the help of neuronavigation, while the other 40 were performed without neuronavigation. Demographic data, preoperative and postoperative radiologic images, craniotomy measurements, surgical complications, and operative times of patients with and without neuronavigation were analyzed. RESULTS Using neuronavigation significantly increased surgery duration (P=0.023). In 6 patients without the use of neuronavigation, the craniotomy had to be enlarged and this resulted in superior sagittal sinus (SSS) damage (P=0.77, P=0.107). Patients for whom neuronavigation was used did not experience any sinus damage and did not require craniotomy enlargement. Postoperative epidural hematoma (EH) developed in 9 patients without navigation, whereas it developed in only 1 patient with navigation (P=0.104). Residual tumors were less common in patients using navigation (P=0.237). CONCLUSIONS The use of neuronavigation allows the incision and craniotomy to be reduced in size. Intraoperatively, it allows the surgeon to master the boundaries of the tumor and surrounding vascular structures, reducing the risk of complications. These results suggest that neuronavigation systems are an effective ancillary in meningioma surgery.
BrainLab VectorVision 神经导航系统是一种术中使用的无框架定位系统,包括用于查看和分析手术显微镜图像的计算机工作站。本回顾性研究旨在评估 2013 年至 2023 年间 80 例颅内脑膜瘤患者使用 BrainLab VectorVision 基于红外线的神经导航成像系统的情况。
回顾性收集了 2013 年至 2023 年间 36 例凸面脑膜瘤和 44 例矢状窦旁脑膜瘤患者的数据。其中 40 例患者的手术在神经导航的帮助下进行,而另外 40 例患者的手术则没有使用神经导航。分析了有和没有神经导航的患者的人口统计学数据、术前和术后影像学图像、颅骨切开术测量、手术并发症和手术时间。
使用神经导航显著增加了手术时间(P=0.023)。在没有使用神经导航的 6 例患者中,需要扩大颅骨切开术,导致上矢状窦(SSS)损伤(P=0.77,P=0.107)。使用神经导航的患者没有发生窦损伤,也不需要扩大颅骨切开术。9 例无导航患者术后发生硬膜外血肿(EH),而 1 例有导航患者发生(P=0.104)。使用导航的患者中残留肿瘤较少(P=0.237)。
神经导航的使用可以减少切口和颅骨切开术的大小。术中,它可以让外科医生掌握肿瘤和周围血管结构的边界,降低并发症的风险。这些结果表明,神经导航系统是脑膜瘤手术的有效辅助手段。