Original Article

Neurosurgical Review

, Volume 35, Issue 3, pp 351-358

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

The role of neuronavigation in intracranial endoscopic procedures

  • Veit RohdeAffiliated withDepartment of Neurosurgery, University of AachenDepartment of Neurosurgery, Georg-August-University Göttingen Email author 
  • , Timo BehmAffiliated withDepartment of Neurosurgery, Georg-August-University Göttingen
  • , Hans LudwigAffiliated withDepartment of Neurosurgery, Georg-August-University Göttingen
  • , Dorothee WachterAffiliated withDepartment of Neurosurgery, Georg-August-University Göttingen

Abstract

In occlusive hydrocephalus, cysts and some ventricular tumours, neuroendoscopy has replaced shunt operations and microsurgery. There is an ongoing discussion if neuronavigation should routinely accompany neuroendoscopy or if its use should be limited to selected cases. In this prospective clinical series, the role of neuronavigation during intracranial endoscopic procedures was investigated. In 126 consecutive endoscopic procedures (endoscopic third ventriculostomy, ETV, n = 65; tumour biopsy/resection, n = 36; non-tumourous cyst fenestration, n = 23; abscess aspiration and hematoma removal, n = 1 each), performed in 121 patients, neuronavigation was made available. After operation and videotape review, the surgeon had to categorize the role of neuronavigation: not beneficial; beneficial, but not essential; essential. Overall, neuronavigation was of value in more than 50% of the operations, but its value depended on the type of the procedure. Neuronavigation was beneficial, but not essential in 16 ETVs (24.6%), 19 tumour biopsies/resections (52.7%) and 14 cyst fenestrations (60.9%). Neuronavigation was essential in 1 ETV (2%), 11 tumour biopsies/resections (30.6%) and 8 cyst fenestrations (34.8%). Neuronavigation was not needed/not used in 48 ETVs (73.9%), 6 endoscopic tumour operations (16.7%) and 1 cyst fenestration (4.3%). For ETV, neuronavigation mostly is not required. In the majority of the remaining endoscopic procedures, however, neuronavigation is at least beneficial. This finding suggests integrating neuronavigation into the operative routine in endoscopic tumour operations and cyst fenestrations.

Keywords

Neuroendoscopy Neuronavigation Third ventriculostomy