Neuro-navigation: An Adjunct in Craniofacial Surgeries: Our Experience

Area of Science:

• Neurosurgery
• Otolaryngology
• Skull Base Surgery

Background:

• Anatomical orientation is challenging during frontobasal or clival tumor surgery due to destroyed osseous landmarks.
• Neuro-navigation guidance may offer a solution for improved surgical orientation.

Purpose of the Study:

• To explore the utility of neuro-navigation in an interdisciplinary setting for skull base tumor surgery.
• To assess the safety and reliability of neuro-navigation in complex craniofacial approaches.

Main Methods:

• Three patients with frontobasal or clival tumors underwent surgery using Lefort-I access osteotomy.
• Procedures were planned and assisted by neuro-navigation with CT-MRI image fusion.
• Diagnoses included clival chordoma and extensive juvenile nasopharyngeal angiofibroma (JNA).

Main Results:

• Neuro-navigation proved safe and reliable for tumor delineation and identification of vital structures.
• No perioperative mortality occurred.
• Complete or subtotal tumor resection was achieved in all cases.

Conclusions:

• Craniofacial approaches with intra-operative neuro-navigational guidance enable safe resection of large anterior skull base tumors.
• Multidisciplinary settings benefit from neuro-navigation in complex skull base surgeries.
• Advanced navigation techniques are ideal for skull base surgery due to the lack of intraoperative structural shift.