Abstract
The role of neuronavigation for complications in temporal lobe epilepsy surgery was evaluated. Thirty-seven patients operated on with neuronavigation (group N: 38 operations; mean age 33.9 years; etiology: cryptogenetic 31, symptomatic 7; lateralization: 22 right, 16 left) and 22 patients operated on without neuronavigation (group NN: 23 operations; mean age 29.7 years; etiology: cryptogenetic 9, symptomatic 14; lateralization: 13 right; 10 left) were analyzed. The minimal follow-up time was 2 years. There was a clear difference in the number of complications (N 7.9%; NN 21.7%), which consisted of hemiparesis (N: 1; NN: 2), cranial nerve palsy (N: 1; NN: 2), aphasia (N: 1; NN: 0), and postoperative infection (N: 0; NN: 1). In addition, there was a reduced need for temporal re-resection after intraoperative electrocorticography (N 30.6%; NN 47.1%). Operation time (N: 239±9.4 min; NN: 208±12.1 min), duration of postoperative in-hospital and in-ICU stay [N: 16.9±1.1 days (1.0±0.0 days); NN: 17.2±2.8 days (1.1±0.1 days)], extension of temporal lobe resection from polar (N: 41.2±1.5 cm; NN: 42.9±3.9 cm), and postoperative seizure frequency reduction (N 90.4%; NN 94.7%) were not different. Because of the trend towards a reduction of complications and re-resections after electrocorticography, the authors recommend neuronavigation despite its higher costs as an additional tool in epilepsy surgery.
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Acknowledgments
The authors gratefully acknowledge the expert support of Mrs. Ilgert and Mrs. Janke with preparation of the figures.The authors are also in debt to the technicians of the epilepsy unit for continuous help with data acquisition. The authors state that they do not have any financial interest in the device under discussion in the paper.
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Oertel, J., Gaab, M.R., Runge, U. et al. Neuronavigation and complication rate in epilepsy surgery. Neurosurg Rev 27, 214–217 (2004). https://doi.org/10.1007/s10143-004-0324-y
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DOI: https://doi.org/10.1007/s10143-004-0324-y