Endoscopic endonasal transphenoidal surgery using the BrainLAB® Headband for navigation without rigid fixation

Area of Science:

• Neurosurgery
• Skull Base Surgery
• Endoscopic Surgery

Background:

• The endoscopic endonasal, transsphenoidal approach is increasingly used for skull base resections.
• Traditional neuronavigation methods often rely on adhesive-mounted fiducial registration, which can be cumbersome.

Purpose of the Study:

• To evaluate a novel surgical navigation technique using laser surface scanning for endoscopic endonasal resection of pituitary lesions.
• To compare the advantages and safety of this technique against conventional neuronavigation methods.

Main Methods:

• Sixty-three consecutive patients with pituitary lesions underwent endoscopic endonasal surgery.
• Surgical navigation was performed using BrainLAB reference headband and laser surface scanning.
• Patient head positioning was flexible, without the need for rigid fixation in a Mayfield clamp.

Main Results:

• The technique was successfully applied in all 63 patients.
• Laser surface scanning navigation offered advantages in head positioning flexibility, allowing better exposure of the clivus and anterior skull base.
• The method proved to be safe, easy-to-use, and faster than other navigation techniques.

Conclusions:

• Laser surface scanning with a reference headband provides a safe, effective, and efficient navigation method for endoscopic endonasal pituitary surgery.
• This technique overcomes limitations of traditional neuronavigation, enhancing surgical flexibility and exposure.