Assessment of necessity of neuronavigation in localization of calvarial extra-axial lesions in the setting of limited resources

Abstract

Background Neuronavigation is a very beneficial tool in modern neurosurgical practice. However, the neuronavigation is not available in most of the hospitals in our country raising the question about its importance in localizing the calvarial extra-axial lesions and to what extent it is safe to operate without it. Methods We studied twenty patients with calvarial extra-axial lesions who underwent surgical interventions. All lesions were preoperatively located with both neuronavigation and the usual linear measurements. Both methods were compared regarding the time consumed to localize the tumor and the accuracy of each method to anticipate the actual center of the tumor. Results The mean error of distance between the planned center of the tumor and the actual was 6.50 ± 1.762 mm in conventional method, whereas the error was 3.85 ± 1.309 mm in IGS method. Much more time was consumed during the neuronavigation method including booting, registration, and positioning. A statistically significant difference was found between the mean time passed in the conventional method and IGS method (2.05 ± 0.826, 24.90 ± 1.334, respectively), P-value < 0.001. Conclusion In the setting of limited resources, the linear measurement localization method seems to have an accepted accuracy in the localization of calvarial extra-axial lesions and it saves more time than neuronavigation method.

Falcotentorial Meningiomas: Optimal Surgical Planning and Intraoperative Challenges - Case Report and a Review

“…16 Hemiparesis, hemidysesthesia, tetraparesis, neglectsyndrome, and postoperative intraventricular hemorrhage were described in the literature. 16,43 Our patient developed superior temporal homonymous quadrantanopia in the immediate postoperative period, permanently, without other neurological symptoms. ►Table 3 summarizes the most relevant reports in the literature from the past 10 years, focusing on the surgical approach, outcomes, and complications.…”

“…Currently, some studies suggest that a supracerebellar infratentorial approach could be difficult in patients presenting a steep tentacle and, in these cases, the occipital transtentorial/transfalcine approach seems to be better. 42,43 Occipital bitranstentorial/falcine approach:This approach was first described by Sekhar et al in 2002. 15,44 This surgical approach is recommended particularly for large pineal tumors with supra-and infratentorial extension or for those with a significant lateral extension.…”

“…17 Adjuvant radiosurgery is recommended for high-grade histopathological tumor lesions and tumors without Simpson I resection. 43…”

“…Currently, some studies suggest that a supracerebellar infratentorial approach could be difficult in patients presenting a steep tentacle and, in these cases, the occipital transtentorial/transfalcine approach seems to be better. 42 43…”

An Observational Comparative Study to Evaluate the Use of Image-Guided Surgery in the Management and Outcome of Supratentorial Intracranial Space-Occupying Lesions

“…Neuronavigation helps in studying anatomy better, which further helps in better planning of surgery and localization of lesions and, in turn, helps better resection, improves surgical safety and efficacy, and reduces hospital stays and surgery costs. [ 4 5 ]…”