An intraoperative motor tract positioning method in brain tumor surgery: technical note
| Autor: | Shiro Kobayashi, Koji Adachi, Tomoko Omura, Akira Teramoto, Tadashi Higuchi, Takayuki Kitamura, Akio Morita, Toyoyuki Kojima, Fumio Yamaguchi, Hiroshi Takahashi, Hirotomo Ten |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Tumor resection Brain tumor Pyramidal Tracts Motor tract Brain mapping 03 medical and health sciences 0302 clinical medicine Consciousness Monitors Imaging Three-Dimensional Postoperative Complications Japan Fiducial Markers Medicine Humans Neuronavigation Brain tumor surgery Aged Neurologic Examination Brain Mapping Pyramidal tracts business.industry Brain Neoplasms Motor Cortex Technical note General Medicine Anatomy Glioma Middle Aged medicine.disease Evoked Potentials Motor Electric Stimulation medicine.anatomical_structure Diffusion Tensor Imaging Surgery Computer-Assisted 030220 oncology & carcinogenesis Female business 030217 neurology & neurosurgery Tractography |
| Zdroj: | Journal of neurosurgery. 129(3) |
| ISSN: | 1933-0693 |
| Popis: | Intraoperative 3D recognition of the motor tract is indispensable to avoiding neural fiber injury in brain tumor surgery. However, precise localization of the tracts is sometimes difficult with conventional mapping methods. Thus, the authors developed a novel brain mapping method that enables the 3D recognition of the motor tract for intrinsic brain tumor surgeries. This technique was performed in 40 consecutive patients with gliomas adjacent to motor tracts that have a risk of intraoperative pyramidal tract damage. Motor tracts were electrically stimulated and identified by a handheld brain-mapping probe, the NY Tract Finder (NYTF). Sixteen-gauge plastic tubes were mounted onto the NYTF and inserted in the estimated direction of the motor tract with reference to navigational information. Only the NYTF was removed, leaving the plastic tubes in their places, immediately after muscle motor evoked potentials were recorded at the minimum stimulation current. Motor tracts were electrically identified in all cases. Three-dimensional information on the position of motor tracts was given by plastic tubes that were neurophysiologically placed. Tips of tubes showed the resection limit during tumor removal. Safe tumor resection with an arbitrary safety margin can be performed by adjusting the length of the plastic tubes. The motor tract positioning method enabled the 3D recognition of the motor tract by surgeons and provided for safe resection of tumors. Tumor resections were performed safely before damaging motor tracts, without any postoperative neurological deterioration. |
| Databáze: | OpenAIRE |
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