Abstract
The overall performance of a “pointer” neuronavigation system (the ISG ALLEGRO Viewing
Wand™) in everyday surgical use was evaluated by investigating the practical utility
of the technical set-up for one particular surgical task. The basis of the analysis
was the numerical evaluation of four areas of fundamental importance for most brain
surgery: site and size of craniotomy, localisation of lesion, the trajectory through
the brain, and the delineation of the lesion. In a protocol of 65 patients we based
our examination on a subjective 4-point rating scale ranging from 0 (= no help) to
3 (= very helpful) for each of the four above categories. We investigated the potential
influence of three factors: the lesions histology (4 groups), its size (3 categories)
and the depth from the cortical surface (3 levels). Our experience is that the histology
of the lesions has significant influence on the relative usefulness of neuronavigation
for craniotomy (P < 0.017) and for delineation of the lesion (P < 0.003). We found
neuronavigation most helpful for removing gliomas. Second, this system was found to
be very helpful in locating small, hitherto hard-to-find, lesions (P < 0.01). Lesion's
depth had no effect on the ratings (P > 0.2). Overall, the use of this system led
to more precise skin incisions, better site and size of craniotomies tailored to the
pathology, the trajectory through the brain, and to more precise delineation of the
lesion.
Key words
Neuronavigation - frameless stereotaxy - practical usefulness
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Dr. Günther Kleinpeter
Neurochirurgie, Donauspital
Langobardenstraße 122
1220 Wien
Austria
Phone: +431 28802 3602
Fax: +431 28802 3680
Email: g.kleinpeter@billrothhaus.at