title: The microsurgical treatment of cranio-orbital tumors assisted by intraoperative electrophysiologic monitoring and neuronavigation.
abstract: OBJECTIVE
  Total resection of cranio-orbital tumors without any major complications is still a challenge for neurosurgeons. Intraoperative electrophysiologic monitoring and neuronavigational system have been widely used in microneurosurgery, but their effects during microsurgical treatment of cranio-orbital tumors warrant further investigation.
  
  
  METHODS
  Thirty-eight patients with cranio-orbital tumors admitted to our hospital underwent microsurgery assisted by intraoperative electrophysiologic monitoring. We also simultaneously performed intraoperative neuronavigation in 20 patients. A retrospective review of clinical notes, operation records and prognoses of all patients was performed.
  
  
  RESULTS
  Gross total resection was achieved in 29 patients (76%), near total resection in 5 (13%), subtotal resection in 3 (8%) and partial resection in 1 (3%). With the helps of electromyogram (EMG) monitoring of levator palpebrae superioris (LPS) muscle and navigation system, no surgical damages to the oculomotor nerve and other important structures occurred. A follow-up study showed that 31 patients (82%) resumed normal lives (Glasgow Outcome Scale (GOS) score 5), 5 patients (13%) had independent lives (GOS score 4), and 2 patients (5%) were unable to live independently (GOS score 3).
  
  
  CONCLUSIONS
  Microsurgical treatment assisted by intraoperative electrophysiologic monitoring and neuronavigation might be a useful method for resection of cranio-orbital tumors, especially better for protection of the important cranial nerve and structure in the kull base.
authors.affiliation: Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province 710032, PR China.
authors.forename: Dakuan
authors.initials: D
authors.lastname: Gao
authors.forename: Zhou
authors.initials: Z
authors.lastname: Fei
authors.forename: Xiaofan
authors.initials: X
authors.lastname: Jiang
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhang
authors.forename: Weiping
authors.initials: W
authors.lastname: Liu
authors.forename: Luoan
authors.initials: L
authors.lastname: Fu
authors.forename: Bing
authors.initials: B
authors.lastname: Li
authors.forename: Jingwen
authors.initials: J
authors.lastname: Liang
mesh_terms: D000200:Action Potentials / Q000502:physiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004576:Electromyography; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D038361:Neuronavigation / Q000379:methods*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D015835:Ocular Motility Disorders / Q000209:etiology; D009801:Oculomotor Muscles / Q000473:pathology; D009918:Orbital Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012888:Skull Neoplasms / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology; D055815:Young Adult