Intraoperative Image-Guided Surgery of the Lateral and Anterior Skull Base in Patients with Tumors or Trauma

Abstract

The aim of this investigation was to evaluate the suitability and usefulness of the Stealth Station™ intraoperative guiding system (Medtronic Sofamor Danek, Memphis, TN) in a variety of indications. Eleven intraoperative image-guided procedures were performed for anterior or lateral skull base lesions. The most common neurosurgical approaches included frontal, coronal, and parietotemporal access. Neuronavigation reliably allowed the extent of tumor configuration and risk zones (e.g., blood vessels) to be visualized. Thus, gross tumor resection was achieved in 6 of 7 patients and facilitated reconstruction by the maxillofacial surgeon, resulting in radiologically symmetrical and clinically satisfying results. Postoperatively, one patient was blind from a continuity defect of the optic nerve caused by a bone fragment. Despite destruction of anatomical landmarks related to tumor invasion or intraoperative bone removal, neuronavigation proved helpful in the reconstruction of bony structures. Overall, the use of neuronavigation in interdisciplinary surgery for complicated tumors or trauma of the anterior or lateral skull base allows more radical resection associated with less morbidity.