神经导航辅助锁孔手术治疗功能区小病灶

Neuronavigator-assisted Microsurgery through Keyhole Approach for Little Lesions in Cerebral Functional Areas

目的探讨神经导航辅助锁孔显微手术切除脑功能区小病灶的应用价值。方法采用神经导航辅助锁孔显微手术切除18例脑功能区小病灶。术前将影像学资料输入神经导航系统进行三维重建,制定手术计划。术中实时导航指导手术切除范围,分析治疗结果。结果导航平均注册误差(2.05±0.62)mm,平均骨窗直径3.0cm。所有病例术中均准确定位病灶,其病灶全切17例,次全切除1例。术后16例病人恢复良好,原有症状均获得不同程度改善,1例原有神经症状加重,1例出现新的神经功能损害。结论神经导航辅助锁孔显微手术能准确切除脑功能区病灶,减少手术创伤,提高手术效果,降低死亡率、病残率,在显微神经外科手术中具有重要的临床应用价值。

Objective To explore the applied value of neuronavigator-assisted microsurgery through keyhole approach for little lesions in the cerebral functional areas. Methods Before the surgery, the data of a continuous CT or MRI examinations were inputted into the neuronavigation system for three-dimensional reconstruction and designing the operative approach. The neuronavigator-assisted microsurgery through keyhole approach was performed in the 18 patients with little lesions in the cerebral functional areas. Results The mean registration error was （2.05_＋0.62）mm in these patients. The average diameter of the bony window was 3.0 cm. The lesions and structure surrounding them were located accurately during the operation. Of 18 patients, 17 received total resection of the lesions, and 1 subtotal. The neurological symptoms were improved or unchanged in 16 patients, deteriorated in 1 and new neurological defect appeared in 1. Conclusions The little lesions in the cerebral functional areas can be accurately resected by the neuronavigator-assisted microsurgery through keyhole approach, which has merits such as minimal side injury from the operation and good curative effect, and it should be expansively applied to the patients with little intracranial lesions, especially in the cerebral functional areas.