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Frameless and Maskless Stereotactic Navigation with a Skull-Mounted Tracker.

Andrew A Fanous¹, Timothy G White², Matthew B Hirsch³

¹Departments of Neurological Surgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.

World Neurosurgery

|March 17, 2017

Summary

This study introduces a skull-mounted tracker for image-guided neurosurgery, improving head and neck lesion access and ventricular catheter placement. The novel system enhances surgeon confidence and safety while reducing operating time compared to traditional methods.

Keywords:

Face mask Frameless navigation Skull-mounted tracker

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Area of Science:

Neurosurgery
Medical Imaging
Surgical Navigation

Background:

Intraoperative navigation is crucial in neurosurgery, enhancing surgeon confidence and safety.
Traditional navigation methods like fiducials and facial masks can be associated with complications.
The Weber-Ferguson approach is often used for facial incisions in skull base surgery.

Observation:

A novel intraoperative navigational system utilizing a skull-mounted tracker was employed.
The system was used in three cases: one anterior skull base tumor removal and two ventricular catheter placements.
This approach obviates the need for fiducials or face masks during the surgical procedure.

Findings:

The skull-mounted tracker system demonstrated precision and ease of use in anterior skull base surgery and ventricular catheter placement.
The technique allows for free movement of the head during surgery, facilitating lesion exposure.
Compared to traditional frame-based stereotaxy, this method is less time-consuming and cumbersome.

Implications:

This skull-mounted navigation system offers improved anatomic localization and shorter operating times.
It avoids complications associated with rigid head fixation frames.
The technique enhances surgical efficiency and patient safety in complex neurosurgical procedures.