Related Experiment Video
Updated: Nov 3, 2025
09:53
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
3.9K
Intraoperative MRI in trans-sphenoidal surgery using frameless stereotaxis
Mitchell Stanton1, Joyce Antony1, Teresa Withers1
1Department of Neurosurgery, Gold Coast University Hospital, Southport, Queensland, Australia.
Surgical Neurology International
|June 4, 2021
Summary
Frameless stereotaxis combined with intraoperative MRI (iMRI) enhances pituitary surgery safety and efficiency. This approach improves tumor resection and reduces costs, marking a significant advancement in neurosurgical techniques.
Area of Science:
- Neurosurgery
- Medical Imaging
- Surgical Navigation
Background:
- Intraoperative magnetic resonance imaging (iMRI) has been utilized in pituitary surgery for two decades.
- The advent of frameless stereotaxis has enhanced navigation for both ENT and neurosurgeons.
- This technology offers greater flexibility in patient head positioning, optimizing resection and improving operational safety.
Purpose of the Study:
- To describe and investigate the application of frameless stereotaxis with iMRI in pituitary surgery.
- To evaluate the procedural nuances and impact of this combined technique.
Main Methods:
- A retrospective case series of 47 patients undergoing iMRI-guided trans-sphenoidal debulking using frameless stereotaxis.
- Data collected from January 2016 to June 2019.
- Utilized the AxiEM (Medtronic, USA) tracker within a "twin-operating" model.
Main Results:
- The study included 47 patients with a mean age of 55 years, predominantly female.
- Average lesion size was 20 mm, with visual deterioration being the primary surgical indication.
- iMRI identified two cases of suboptimal decompression, enabling further resection, and one hemorrhagic complication requiring intervention.
Conclusions:
- Frameless stereotaxis with iMRI offers procedural advantages in transsphenoidal surgery.
- This technique can reduce patient morbidity and enhance surgical outcomes.
- Improved theater utilization and cost reduction are additional benefits.
