Neuro-navigation: An Adjunct in Craniofacial Surgeries: Our Experience

Faciomaxillary Surgery, D.A.P.M.R.V. Dental College and Hospital, Bangalore, India.
Journal of Maxillofacial and Oral Surgery 12/2011; 10(4):296-300. DOI: 10.1007/s12663-011-0245-6
Source: PubMed


Due to the destruction of osseous landmarks of the skull base or paranasal sinuses, the anatomical orientation during surgery of frontobasal or clival tumors with (para) nasal extension is often challenging. In this relation, Neuro-navigation guidance might be a useful tool. Here, we explored the use of Neuro-navigation in an interdisciplinary setting.
The surgical series consists of 3 patients who underwent Lefort-I access osteotomy and surgical decompression of the tumor. The procedures were planned and assisted by neuro-navigation techniques with image fusion of CT and MRI. Two of the patients were diagnosed to have clival chordoma and one had extensive JNA.
The application of Neuro-navigation in the combined approaches was both safe and reliable for delineation of tumors and identification of vital structures hidden or encased by the tumors. There was no perioperative mortality. Tumors were either removed completely, or subtotal resection was achieved.
Craniofacial approaches with intra-operative neuro-navigational guidance in a multidisciplinary setting allow safe resection of large tumors of the upper clivus and the paranasal sinuses involving the anterior skull base. Complex skull base surgery with the involvement of bony structures appears to be an ideal field for advanced navigation techniques given the lack of intraoperative shift of relevant structures.

4 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study aimed to investigate the clinical significance of 3-dimensional (3D) reconstruction of peripancreatic vessels for patients with suspected pancreatic cancer (PC). A total of 89 patients with PC were included; 60 patients randomly underwent computed tomographic angiography. Based on the findings of 3D reconstruction of peripancreatic vessels, the appropriate method for individualized tumor resection was determined. These patients were compared with 29 conventionally treated patients with PC. The rate of visualization was 100% for great vessels around the pancreas. The detection rates for anterior superior pancreaticoduodenal artery, posterior superior pancreaticoduodenal artery, anterior inferior pancreaticoduodenal artery, posterior inferior pancreaticoduodenal artery, dorsal pancreatic artery, superior marginal arterial branch of the pancreatic head, anterior superior pancreaticoduodenal vein, posterior superior pancreaticoduodenal vein, anterior inferior pancreaticoduodenal vein, and posterior inferior pancreaticoduodenal vein were 86.6%, 85.0%, 76.6%, 71.6%, 91.6%, 53.3%, 61.6%, 55.0%, 43.3%, and 51.6%, respectively. Forty-three patients who had undergone 3D reconstruction underwent surgery. Of the 29 conventionally treated patients, 19 underwent surgery. The operative time, blood loss, length of hospital stay, and complication incidence of the 43 patients were superior to that of the 19 patients. A peripancreatic vascular reconstruction can reveal the vascular anatomy, variations of peripancreatic vascular, and tumor-induced vascular changes; the application of the simulation surgery platform could reduce surgical trauma and decrease operative time.
    Pancreas 04/2014; 43(3):389-95. DOI:10.1097/MPA.0000000000000035 · 2.96 Impact Factor


4 Reads
Available from