신경항법장치를 이용한 두개저외과수술의 장점

Abstract

Objective : Skull base tumors frequently encase or extend into vital neurovascular structures. Preoperative planning and intraoperative identification of anatomic landmarks is important in complex tumors since it helps avoid or minimize surgical morbidity. The purpose of this study was to describe the usefulness of recent advances of neuronavigation technology in the management of skull base tumors. Patients and Methods : From March 2006 to May 2008, 32 patients underwent neuronavigation-assisted surgery for skull base tumors. A Stryker Leibinger system was used for neuronavigation. Results : The use of neuronavigation was beneficial both pre-and intraoperatively. Gross total removal of the skull base tumors was accomplished in 29 out of 32 patients who were confirmed with postoperative CT and MRI scans. All tumors were removed completely as judged by intraoperative inspection in all patients except for three. The morbidity rates (18.8%) were different depending on the performed surgical approaches. Conclusions : Image guidance facilitates complex approaches to various pathologies and enables mapping of skull base anatomy, especially during translesional dissection of complex tumors distorting and invading the neurovascular and osseous structures. Neuronavigation will enhance the efficacy and safety of skull base surgery. Skull base surgery is the best target for it because of the minimum possible brain shift.