无框架MRI导航下的内镜经蝶鞍区肿瘤切除术

Frameless MRI image-guided endoscopic transsphenoidal removal of tumor in sellar region

目的探讨无框架MRI导航系统在内镜经蝶垂体腺瘤和颅咽管瘤切除术中的作用。方法对8例垂体腺瘤和2例颅咽管瘤病人在无框架MRI影像导航引导内镜下经蝶入路切除肿瘤。结果机器定位误差平均1.5mm,重要结构和病变定位满意,导航注册时间平均5 min,手术时间平均50 min,术后病人症状均减轻。结论在内镜经蝶鞍区手术治疗中,无框架影像导航使重要结构及病变定位准确,可在手术中发挥重要作用。

Objective To assess the role of frameless MRI image-guided neuronavigation in assisting endoscopic transsphenoidal surgery for pituitary adenomas and craniopharyngioma. Methods 10 endoscopic endonasal transsphenoidal operations were performed for 8 patients with pituitary adenomas and 2 with craniopharyngioma. Clinical records were reviewed retrospectively. Results Measurements of the intraoperative accuracy in the axial, coronal, and sagittal planes indicated a mean intraoperatively verified system error of 1.5mm, and the continuous information regarding instrument location and trajectory was provided to the surgeon. The mean setup time was 5 minutes, and the operative time was 50 minutes in image-guided procedures. In all cases, we found that the system performed without malfunction. Conclusions Neuronavigation can be applied during endonasal transsphenoidal endoscopic surgery and requires a minimal amount of time. It makes the operation easier, faster, and probably safer.