We evaluated the surgical treatment of sensorimotor cortex lesions performed under the guidance of intraoperative ultrasonography integrated into neuronavigation.
STUDY DESIGN
Eighteen patients (10 males, 8 females; mean age 43 years; range 3 to 67 years) underwent surgery for cortical or subeortical lesions under the guidance of intraoperative ultrasonography integrated into neuronavigation. Preoperative navigation planning included localization of the central sulcus in the normal hemisphere followed by localizations of the lesion and the central sulcus on the involved side. Findings of the neurologic examination obtained preoperatively, in the early postoperative period, and at the end of the fırst month were compared.
RESULTS
The mean registration accuracy provided by the system was 0.7 mm (range 0.4 to 1.2 mm). Through neuronavigation, the central sulcus was correctly defined in the normal hemisphere in all cases, and in 14 cases on the involved side. Total resection was performed in 14 patients and subtotal resection in four patients. Of motor neurologic deficits detected in 15 patients preoperatively, 95% improved at the end of the fırst postoperative month. Mortality and morbidity rates were 0% and 5.5%, respectively.
CONCLUSION
The integration of intraoperative ultrasonography into neuronavigation highly improves the accuracy of craniotomy and localizaton of the cortical or subcortical lesions of the sensorimotor cortex.