scholarly journals Real-Time Navigation-Guided Drilling Technique for Skull Base Surgery in the Middle and Posterior Fossae

2018 ◽  
Vol 79 (S 04) ◽  
pp. S334-S339 ◽  
Author(s):  
Tetsuya Goto ◽  
Yosuke Hara ◽  
Kazuhiro Hongo ◽  
Toshihiro Ogiwara

Objective The usefulness of the bony surface registration method for navigation system image-guided surgery in the lateral or prone position has been reported. This study was performed to evaluate the efficacy of our new real-time navigation-guided drilling technique with bony surface registration for skull base surgery in the middle and posterior fossae. Methods The study included 29 surgeries for skull base tumors that required drilling of the petrous bone between January 2015 and December 2017 in Shinshu University Hospital. A navigation system was used for drilling of the petrous bone as follows: (1) some labyrinthine structures were marked by color in the source image and superimposed on the navigation image on the workstation preoperatively; (2) bony surface registration was performed with a three-dimensional (3D) skull reconstruction model in the operating room; (3) the petrous bone was drilled under navigation guidance with real-time view-through confirmation of 3D color-marked labyrinthine structures with observation under a microscopic operative view. Results Real-time identification of some structures in the petrous bone was performed, and adequate and precise drilling of the petrous bone was achieved without the risk of labyrinthine perforation or stress. Using this method, surgeons do not need to alternate their gaze between the surgical field and the navigation screen. Conclusions Due to the development of bony surface registration, this new technique is useful for drilling petrous bone in the middle and posterior fossa skull base surgeries.

PLoS ONE ◽  
2017 ◽  
Vol 12 (7) ◽  
pp. e0180975 ◽  
Author(s):  
Tanja Daniela Grauvogel ◽  
Paul Engelskirchen ◽  
Wiebke Semper-Hogg ◽  
Juergen Grauvogel ◽  
Roland Laszig

2015 ◽  
pp. 801-803
Author(s):  
B. Oliver ◽  
B. Zurita ◽  
J. Molet ◽  
R. Ram�rez ◽  
M. Quer ◽  
...  

2015 ◽  
Vol 157 (11) ◽  
pp. 2017-2022 ◽  
Author(s):  
Toshihiro Ogiwara ◽  
Tetsuya Goto ◽  
Tatsuro Aoyama ◽  
Alhusain Nagm ◽  
Yasunaga Yamamoto ◽  
...  

2019 ◽  
Vol 131 (5) ◽  
pp. 1658-1667 ◽  
Author(s):  
Kenichiro Iwami ◽  
Masazumi Fujii ◽  
Yugo Kishida ◽  
Shinya Jinguji ◽  
Masayuki Yamada ◽  
...  

OBJECTIVEAlthough sphenoidotomy is more commonly performed via the transnasal approach than via the transcranial approach, transcranial sphenoidotomy (TCS) remains indispensable for en bloc resection of locally advanced sinonasal malignant tumors (SNMTs) extending to the skull base. TCS also enables transsphenoidal transposition of the temporoparietal galeal flap (TPGF) to compensate for the lack of vascularized reconstructive tissue after endoscopic transnasal skull base surgery. The objective of this study was to review the authors’ surgical experience using TCS with an emphasis on the surgical anatomy of the sphenoid sinus and on the purpose of TCS. Relevant anatomy is further illustrated through cadaveric dissection and photo documentation.METHODSThe authors reviewed the records of 50 patients who underwent TCS at the Nagoya University Hospital, Fukushima Medical University Hospital, or Aichi Medical University Hospital over the course of 7 years (between January 2011 and November 2017). The authors also performed cadaveric dissection in 2 adult cadaveric skull base specimens.RESULTSOf the 50 patients included in this study, 44 underwent craniofacial resection (CFR) for en bloc resection of SNMTs involving the anterior and/or lateral skull base, and 6 underwent transsphenoidal transposition of the TPGF flap. The authors categorized the TCS procedures according to the portion of the sphenoid sinus wall involved (i.e., superior, lateral, and superolateral). Superior sphenoidotomy was used in patients requiring anterior CFR. Lateral sphenoidotomy was further divided into 2 subtypes, with type 1 procedures performed for the transsphenoidal transpositioning of the TPGF, and type 2 procedures used in patients requiring lateral CFR. Superolateral sphenoidotomy was used in anterolateral CFR.CONCLUSIONSTCS still represents a useful tool in the armamentarium of neurosurgeons treating central skull base lesions. The newly proposed surgical classification facilitates a profound understanding of TCS and how to incorporate this technique into clinical practice.


2012 ◽  
Vol 73 (S 01) ◽  
Author(s):  
Benjamin Dixon ◽  
Michael Daly ◽  
Harley Chan ◽  
Allan Vescan ◽  
Ian Witterick ◽  
...  

2005 ◽  
Vol 48 (3) ◽  
pp. 181-185 ◽  
Author(s):  
R. Marmulla ◽  
G. Eggers ◽  
J. Mühling

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