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  • Recognition of Neural Tracts in Brain Tumor Surgery for Patients’ Quality of Life and Medical Safety

    Final Number:
    433

    Authors:
    Fumio Yamaguchi MD, PhD; Hirotomo Ten MD, PhD; Tadashi Higuchi MD; Tomoko Omura; Koji Adachi; Takayuki Kitamura; Akio Morita MD, PhD

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: The preservation of motor tract in glioma surgery is an essential issue to maintain the patients’ quality of life. Information from DTI in neuronavigation image is not reliable due to brain edema and intraoperative brain shift. The best way to recognize the under-passing motor tract is real-time intraoperative neurophysiological identification of motor fibers.

    Methods: An electrode (NY Tract Finder) designed for navigation-assisted detection of motor tract in cerebral white matter, was used during the resection of 38 gliomas adjacent to motor tract. Multiple plastic needle sheaths were placed to track the motor fibers for surgical guidance after subcortical mapping. Neuronavigational information was used to determine the inserting direction but not the depth.

    Results: The tracking of motor fibers was practicable in surgical field. Inserted plastic tubes enabled the recognition of under-passing motor pathways even if they were not exposed. This method could guide safe resection of tumors without the injury of functioning motor fibers. No postoperative neurological deterioration occurred.

    Conclusions: Three-dimensional Recognition of Neural Tracts is feasible by this method. Safe tumor resections result in protecting Patients’ Quality of Life and Medical Safety for Brain Tumor Surgery.

    Patient Care: By developing unique technique for intraoperative neuro-recognition, the safe brain tumor surgery become possible.

    Learning Objectives: Audience will learn the technique of intraoperative recognition of neural tracts and the importance of neurological preservation for patient's quality of life and medical safety.

    References:

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