Multimodal holography-assisted surgical resection of meningioma in the central region
Objective To investigate the application value of multimodal holographic imaging technique in surgical removal of meningioma in the central region.Methods Thirteen patients with central region meningiomas admitted into the neurosurgery department from June 2021 to October 2022 were selected as observation group.There were 2 cases of parafalcine meningiomas,6 cases of parasagittal and parafalcine meningiomas,and 5 cases of convexity meningiomas.Preoperatively,computed tomography(CT)and magnetic resonance imaging(MRI)were performed in 13 patients.The three-dimensional models of skull,tumor,cerebral cortex and superior sagittal sinus were made using 3DSlicer,Matlab and Dsi Studio softwares.Under the assistance of holography,the surgical plans were achieved preoperatively and the 13 cases of meningiomas were removed during surgeries.Patients with meningiomas in the central region treated by the same surgeon from January 2020 to May 2021 were selected as the control group.Limb muscle strength 1 week postoperatively was compared between groups.Results In observation group,the curved incisions were made in 3 cases and horseshoe incision were applied in 10 cases during operations.The localizations of all the tumors in 13 cases were exact.The positional relationship of tumor,veins and cerebral cortex was confirmed intraoperatively,which was consistent completely with preoperative reconstructed holography.Eight patients underwent Simpson GradeⅠresection and five received Simpson GradeⅡresection.One week after surgery,normal limb muscle strength was detected in 11 cases.One case developed contralateral upper limb muscle strength of grade Ⅲ and recovered normal 4 weeks postoperatively.One case suffered from contralateral lower limb muscle strength of grade Ⅳ and recovered normal 2-3 weeks postoperatively.One case of cerebral edema was observed during re-examination of cranial CT.The average postoperative hospital stay was 10.23±0.42 days.In the control group,five patients had normal limb muscle strength one week postoperatively,six patients suffered from contralateral lower limb muscle strength of gradeⅣ,four patients had contralateral limb muscle strength of grade Ⅲ,seven patients developed brain edema from CT,and the average postoperative hospital stay was 14.07±0.92days.There were significant differences in muscle strength,incidence of brain edema one week postoperatively,and postoperative hospital stay between the two groups(P<0.05).Conclusion The multimodal holographic imaging technique assists effectively surgical planning and the accurate localization of the central region meningiomas.During the surgeries,the multimodal holography is helpful in the protection of vein of drainage and cerebral cortex of functional region,which reduces the surgical side damage.
meningiomacentral region parafalcine meningiomasuperior sagittal sinusmicrosurgery
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