Use of topical landmarks for percutaneous projection of intracranial tumors for neurosurgical oncology.
OBJECTIVE
The objective of this study was to introduce a surgical navigation method which provides a safe, quick and effective access to cortical and subcortical tumors, along with a review of other methods in use for this purpose.


METHODS
53 patients have been operated using this technique. The area overlying the tumor is shaved and one half of a smoothly cut hazelnut is taped on the skin. The precise localization of the hazelnut is confirmed with MRI and then stained. After general anesthesia, the stained impression is projected firstly to the bone, dura and then cortex respectively by the Midas Rex cutting tip. Cortical landmarks surrounding the tumor's cortical projection are further confirmed with ultrasonography.


RESULTS
After removal, cortical and subcortical tumors were separately graded for efficiency. Grade 1 and 2 were accepted as precise access. Our method accordingly yielded 95.2% and 90.6% success rates for cortical and subcortical tumors respectively.


CONCLUSIONS
Considering the method's success rate along with its inexpensiveness and modest technical requirements, it is believed that this method can be of widespread use.
Ondokuz Mayis University, Faculty of Medicine, Department of Neurosurgery, Samsun, Turkey.
Keramettin
K
Aydin
Ersoy
E
Kocabicak
Adnan
A
Altun
Ilkay
I
Ozaydin
Ercan
E
Yarar
Cengiz
C
Cokluk
D059925:Anatomic Landmarks / Q000601:surgery*; D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery*; D002540:Cerebral Cortex / Q000033:anatomy & histology / Q000601:surgery; D031211:Corylus; D003399:Craniotomy / Q000295:instrumentation / Q000379:methods; D004388:Dura Mater / Q000033:anatomy & histology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D011300:Preoperative Care / Q000379:methods; D012535:Scalp; D012886:Skull / Q000033:anatomy & histology / Q000601:surgery; D013194:Staining and Labeling