title: Awake craniotomy using electromagnetic navigation technology without rigid pin fixation.
abstract: We report our institutional experience using an electromagnetic navigation system, without rigid head fixation, for awake craniotomy patients. The StealthStation® S7 AxiEM™ navigation system (Medtronic, Inc.) was used for this technique. Detailed preoperative clinical and neuropsychological evaluations, patient education and contrast-enhanced MRI (thickness 1.5mm) were performed for each patient. The AxiEM Mobile Emitter was typically placed in a holder, which was mounted to the operating room table, and a non-invasive patient tracker was used as the patient reference device. A monitored conscious sedation technique was used in all awake craniotomy patients, and the AxiEM Navigation Pointer was used for navigation during the procedure. This offers the same accuracy as optical navigation, but without head pin fixation or interference with intraoperative neurophysiological techniques and surgical instruments. The application of the electromagnetic neuronavigation technology without rigid head fixation during an awake craniotomy is accurate, and offers superior patient comfort. It is recommended as an effective adjunctive technique for the conduct of awake surgery.
authors.affiliation: Department of Neurosurgery, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore; Department of Neurosurgery, Zagazig University, Zagazig, Egypt.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Morsy
authors.affiliation: Department of Neurosurgery, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore; Neuroscience Academic Clinical Programme, SingHealth Duke-NUS, Singapore. Electronic address: ng.wai.hoe@singhealth.com.sg.
authors.forename: Wai Hoe
authors.initials: WH
authors.lastname: Ng
mesh_terms: D000328:Adult; D003399:Craniotomy / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation / Q000295:instrumentation* / Q000379:methods*; D014851:Wakefulness
keywords: Awake craniotomy; Electromagnetic neuronavigation; Frameless; Pinless; Stealth; Stereotactic