2004 年 17 巻 3 号 p. 132-135
Achieving tumor resection with as few neurological deficits as possible is the primary goal of brain tumor surgery. Using navigation systems, it is now possible to approach brain tumors more accurately and less invasively, and to resect the tumors more safely using electro-neurophysiological monitoring methods such as SEP, MEP, and ABR. We describe the use of a synchronized navigation system (SonoNavTM), which combines ultrasonography and a navigation system, for real-time monitoring of intraoperative brain shift in addition to the use of these techniques for brain tumor surgery. Before the dural incision after craniotomy, fence post tubes were inserted into the target. The fence post tubes were useful not only for determining the margin of resection, but also for brain shift monitoring. The synchronized navigation system was effective for real-time monitoring of brain shift. The electro-neurophysiological monitoring was effective for preventing neurological deficits after surgery. We conclude that use of a navigation system, ultrasonography and neurophysiological monitoring together contribute to safe, accurate and minimally invasive brain tumor surgery.