RESUMO
Objetivos: Describir la utilidad de la neuronavegación preoperatoria 3D asistida por ordenador para la localización estereoscópica de los senos venosos, ramas arteriales y cuerpo calloso, para extrapolar las referencias anatómicas sobre el campo quirúrgico y tomar decisiones antes de la intervención. Materiales y métodos: Se realizó un análisis prospectivo de los pacientes con epilepsia refractaria que fueron sometidos a callosotomía asistida por neuronavegación (BRAIN LAB Dual). Resultados: En el año 2014 realizamos 10 callosotomías asistidas por neuronavegación. Las edades de los pacientes (4 varones y 6 mujeres) estuvieron entre 4 y 13 años (promedio 7; SD 3,02). La indicación más frecuente de la callosotomía en nuestra muestra fue el síndrome de Lennox Gastoux (5 pacientes). Realizamos craneotomía parasagital derecha en 8 pacientes. La callosotomía se realizó en los 2/3 anteriores en 8 pacientes y en los 3/4 anteriores en 2 pacientes. La precisión del procedimiento de neuronavegación fue en promedio inferior a 2 mm. En ningún caso hubo complicaciones quirúrgicas intraoperatorias significativas. Conclusión: La callosotomía guiada por neuronavegación sin marco es una técnica precisa y segura en pacientes con epilepsia refractaria no tributarios de cirugía resectiva
Objective: To describe the usefulness of 3D computer-assisted preoperative neuronavigation for stereoscopic location of the venous sinuses, arterial branches, and corpus callosum, to extrapolate anatomical landmarks on the surgical field and make decisions before the intervention. Methods: A prospective analysis was performed on patients with refractory epilepsy who underwent neuronavigation-assisted callosotomy (BRAIN LAB Dual). Results: A total of 10 neuronavigation-assisted callosotomies were performed in the year 2014. The ages of the patients (4 males and 6 females) were between 4 and 13 years (mean 7; SD 3.02). The most common indication for callosotomy in our sample was Lennox Gastoux (5 patients). A right parasagittal craniotomy was performed in 8 patients. An anterior two-thirds callosotomy was performed in 8 patients and anterior three-quarters in 2 patients. The mean accuracy of the neuronavigation procedure was less than 2 mm. In no cases were there significant intraoperative surgical complications. Conclusion: Callosotomy using frameless guided neuronavigation is an accurate and safe technique in patients with epilepsy refractory to surgical resection
Assuntos
Humanos , Neuronavegação/métodos , Corpo Caloso/cirurgia , Epilepsia Resistente a Medicamentos/cirurgia , Cirurgia Assistida por Computador/métodos , Imageamento Tridimensional , Estudos Prospectivos , Planejamento de Assistência ao PacienteRESUMO
OBJECTIVE: To describe the usefulness of 3D computer-assisted preoperative neuronavigation for stereoscopic location of the venous sinuses, arterial branches, and corpus callosum, to extrapolate anatomical landmarks on the surgical field and make decisions before the intervention. METHODS: A prospective analysis was performed on patients with refractory epilepsy who underwent neuronavigation-assisted callosotomy (BRAIN LAB Dual). RESULTS: A total of 10 neuronavigation-assisted callosotomies were performed in the year 2014. The ages of the patients (4 males and 6 females) were between 4 and 13 years (mean 7; SD 3.02). The most common indication for callosotomy in our sample was Lennox Gastoux (5 patients). A right parasagittal craniotomy was performed in 8 patients. An anterior two-thirds callosotomy was performed in 8 patients and anterior three-quarters in 2 patients. The mean accuracy of the neuronavigation procedure was less than 2mm. In no cases were there significant intraoperative surgical complications. CONCLUSION: Callosotomy using frameless guided neuronavigation is an accurate and safe technique in patients with epilepsy refractory to surgical resection.
