- 作者：Dakuan Gao ; Zhou Fei ; Xiaofan Jiang ; Xiang Zhang ; Weiping Liu ; Luoan Fu ; Bing Li ; Jingwen Liang
- 关键词：Cranio-orbital tumor ; Microsurgery ; Electrophysiologic monitoring ; Neuronavigation
- 刊名：Clinical Neurology and Neurosurgery
- 出版年：2012
- 出版时间：September, 2012
- 年：2012
- 卷：114
- 期：7
- 页码：891-896
- 全文大小：622 K
Objective
Total resection of cranio-orbital tumors without any major complications is still a challenge for neurosurgeons. Intraoperative electrophysiologic monitoring and neuronavigational system have been widely used in microneurosurgery, but their effects during microsurgical treatment of cranio-orbital tumors warrant further investigation.Methods
Thirty-eight patients with cranio-orbital tumors admitted to our hospital underwent microsurgery assisted by intraoperative electrophysiologic monitoring. We also simultaneously performed intraoperative neuronavigation in 20 patients. A retrospective review of clinical notes, operation records and prognoses of all patients was performed.
Results
Gross total resection was achieved in 29 patients (76 % ), near total resection in 5 (13 % ), subtotal resection in 3 (8 % ) and partial resection in 1 (3 % ). With the helps of electromyogram (EMG) monitoring of levator palpebrae superioris (LPS) muscle and navigation system, no surgical damages to the oculomotor nerve and other important structures occurred. A follow-up study showed that 31 patients (82 % ) resumed normal lives (Glasgow Outcome Scale (GOS) score 5), 5 patients (13 % ) had independent lives (GOS score 4), and 2 patients (5 % ) were unable to live independently (GOS score 3).
Conclusion
Microsurgical treatment assisted by intraoperative electrophysiologic monitoring and neuronavigation might be a useful method for resection of cranio-orbital tumors, especially better for protection of the important cranial nerve and structure in the kull base.