Abstract
Stereotactic brain biopsy using a navigation system is minimally invasive because it can be performed under local anesthesia. However, there are problems due to the localization and accessibility of the tumor and instability of the airway under sedation. This study aimed to examine the differences in safety and surgical time between the supine and lateral position. This study included 25 cases which underwent navigation-guided brain biopsies from May 2015 to March 2018 in the Kanazawa University Hospital. We compared tumor localization, operation time, standby time, intraoperative difficulties, and final diagnosis acquisition rates between the supine and lateral positions. Puncture sites were then examined by visualizing all biopsy trajectories simultaneously on a three-dimensional cerebral template. Biopsies of the tumor in all cerebrum lobes were possible in the lateral position. There were no significant differences in operating time or standby time between the supine and lateral positions. One case in the spine position required sedation by an anesthesiologist due to body movement, but there were no difficulties in any cases of lateral positioning. The final diagnosis acquisition rate was 100% in all cases. In the lateral position, stable breathing was maintained because the head and the trunk axes remined in the same line. Stereotactic brain biopsy in the lateral position can be safer and more useful than in the supine position under local anesthesia.
Published Version
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