Neuronavigation and complication rate in epilepsy surgery.
The role of neuronavigation for complications in temporal lobe epilepsy surgery was evaluated. Thirty-seven patients operated on with neuronavigation (group N: 38 operations; mean age 33.9 years; etiology: cryptogenetic 31, symptomatic 7; lateralization: 22 right, 16 left) and 22 patients operated on without neuronavigation (group NN: 23 operations; mean age 29.7 years; etiology: cryptogenetic 9, symptomatic 14; lateralization: 13 right; 10 left) were analyzed. The minimal follow-up time was 2 years. There was a clear difference in the number of complications (N 7.9%; NN 21.7%), which consisted of hemiparesis (N: 1; NN: 2), cranial nerve palsy (N: 1; NN: 2), aphasia (N: 1; NN: 0), and postoperative infection (N: 0; NN: 1). In addition, there was a reduced need for temporal re-resection after intraoperative electrocorticography (N 30.6%; NN 47.1%). Operation time (N: 239+/-9.4 min; NN: 208+/-12.1 min), duration of postoperative in-hospital and in-ICU stay [N: 16.9+/-1.1 days (1.0+/-0.0 days); NN: 17.2+/-2.8 days (1.1+/-0.1 days)], extension of temporal lobe resection from polar (N: 41.2+/-1.5 cm; NN: 42.9+/-3.9 cm), and postoperative seizure frequency reduction (N 90.4%; NN 94.7%) were not different. Because of the trend towards a reduction of complications and re-resections after electrocorticography, the authors recommend neuronavigation despite its higher costs as an additional tool in epilepsy surgery.
Oertel
Joachim
J
Department of Neurosurgery, Hannover Nordstadt Hospital, 30167, Germany. oertelj@freenet.de
Gaab
Michael Robert
MR
Runge
Uwe
U
Schroeder
Henry Werner Siegfried
HW
Wagner
Wolfgang
W
Piek
Jürgen
J
D000293:Adolescent; D000328:Adult; D038481:Anterior Temporal Lobectomy / Q000009:adverse effects* / Q000379:methods*; D002540:Cerebral Cortex / Q000503:physiopathology; D002648:Child; D004833:Epilepsy, Temporal Lobe / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D038361:Neuronavigation; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome