Use of topical landmarks for percutaneous projection of intracranial tumors for neurosurgical oncology

Abstract

Aim: The objective of this study was to introduce a surgical navigation method which provides a safe, quick and effective access to cortical and subcortical tumors, along with a review of other methods in use for this purpose. Material and Methods: 53 patients have been operated using this technique. The area overlying the tumor is shaved and one half of a smoothly cut hazelnut is taped on the skin. The precise localization of the hazelnut is confirmed with MRI and then stained. After general anesthesia, the stained impression is projected firstly to the bone, dura and then cortex respectively by the Midas Rex cutting tip. Cortical landmarks surrounding the tumors cortical projection are further confirmed with ultrasonography. Results: After removal, cortical and subcortical tumors were separately graded for efficiency. Grade 1 and 2 were accepted as precise access. Our method accordingly yielded 95.2% and 90.6% success rates for cortical and subcortical tumors respectively. Conclusion: Considering the methods success rate along with its inexpensiveness and modest technical requirements, it is believed that this method can be of widespread use.