title: Neuronavigation in cranioorbital neurosurgery - do we really need it?
abstract: OBJECTIVE
  The value of neuronavigation in cranioorbital neurosurgery is controversial and relatively unstudied. The aim of this study was to evaluate the application, the usefulness and the reliability of neuronavigation in the neurosurgical treatment of orbital tumours.
  
  
  METHODS
  A frameless armless infrared-based neuronavigation system was applied in the microsurgical removal of 7 orbital tumors. Image guidance was CT-based in 3 cases, MRI-based in another 3 cases and based on image fusion between CT and MRI image sets in one patient. The extradural fronto-orbital approach was performed in 3 cases, lateral orbitotomy in 2 cases, trans-supraciliar approach in 1 case and inferomedial orbitotomy in 1 case.
  
  
  RESULTS
  The surgical procedures were successful in all cases. The procedure-related morbidity and mortality rate in the series was zero. The registration accuracy of the neuronavigation ranged between 1.0 and 1.7 mm, with an average of 1.3 mm. Neuronavigated image guidance was evaluated as useful in all patients. Total tumour removal was achieved in 5 patients and partial tumour excision in 1 case. One patient was only biopsied.
  
  
  CONCLUSIONS
  Neuronavigation is not a substitute for surgical knowledge and experience, but it is a valuable complement with significant intraoperative potential in cranioorbital surgery.
authors.affiliation: Medical University - Sofia, Department of Neurosurgery, Sofia, Bulgaria. dr.y.enchev@gmail.com
authors.forename: Yavor
authors.initials: Y
authors.lastname: Enchev
authors.forename: Christo
authors.initials: C
authors.lastname: Tzekov
authors.forename: Dilyan
authors.initials: D
authors.lastname: Ferdinandov
authors.forename: Assen
authors.initials: A
authors.lastname: Cekov
authors.forename: Toma
authors.initials: T
authors.lastname: Spiriev
mesh_terms: D000328:Adult; D003399:Craniotomy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D038361:Neuronavigation / Q000379:methods* / Q000592:standards* / Q000706:statistics & numerical data; D009915:Orbit / Q000601:surgery*; D009918:Orbital Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed