Türk Nöroşirürji Dergisi 2023 , Vol 33 , Num 1
Stereotaxic Surgery in Childhood: Differences from Adult Cases
Barış ALBUZ1,Emrah EGEMEN2,Murat VURAL3
1Fatih Devlet Hastanesi, Beyin ve Sinir Cerrahisi Kliniği, Trabzon, Türkiye
2Pamukkale Üniversitesi Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Denizli, Türkiye
3Osmangazi Üniversitesi Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Eskişehir, Türkiye
Stereotaxic surgery is used to find small lesions in the body and perform some actions on them. Here, a minimally invasive intervention is applied using a three-dimensional coordinate system. It is frequently used in childhood in catheter placement, cyst drainage, radiosurgery, brachytherapy, deep brain stimulation (DBS), invasive neurophysiological examination and tumour biopsy. Additionally, in computed tomography (CT) or magnetic resonance imaging (MRI) obtained for preoperative evaluation, the scan slices must be narrowly spaced and thin enough (e.g. 3 mm) to allow accurate target identification, and the field of view must include the nose and eyes used as surface markers for intraoperative recording. Although it can be applied using frame-based and frameless systems, there is still a gap in the literature regarding the safety, applicability, and pin-related complications of the frame-based technique in paediatric patients. In addition, a few problems with halo fixation in childhood have been reported, such as loosening and dislocation of pins, infection at the pin site, skull fracture or penetration followed by subdural and epidural hematomas, venous air embolism, and arteriovenous fistula. Frameless stereotaxy systems are complementary to frame-based techniques but needs to be more precise to replace or preclude the traditional halo pin frame. Anahtar Kelimeler : Stereotaxic frame, Frameless navigation systems, Tumour biopsy, Deep brain stimulation