The purpose of this study was to achieve a more radical resection of tumors in the
area of the motor cortex via minimal craniotomy using a combination of neuronavigation
and neurophysiological monitoring with direct electrical cortical stimulation and
to compare retrospectively the clinical outcome and postoperative magnetic resonance
imaging with a control group that was operated on in our service when the combination
of these monitoring techniques was not available. A total of 42 patients with tumors
in or near the central region underwent surgery with neuronavigation guidance and
neurophysiological monitoring. The primary motor cortex was identified intraoperatively
by the somatosensory evoked phase reversal method and direct cortical stimulation.
The functional areas were transferred into the neuronavigation system. By stimulating
the identified primary motor cortex and displaying the motor area in the operating
microscope a permanent control of the motor function was possible during the whole
operation. Using these techniques a more radical tumor resection - evaluated by postoperative
MRI - was achieved in the study group (p = 0.04) and also a trend toward a better
neurological outcome.
Neuronavigation - neurophysiological monitoring - central region tumors - retrospective
study
