Improved Intraoperative Visualization Enhances Resection of Skull Base Tumors

Orin Bloch, MD, discusses why image guided surgery is preferable over “look and feel” or navigating from MRI alone during skull base tumor resection. Dr. Bloch uses two cases to demonstrate how visualization benefits minimalist (keyhole cranio-orbital) and maximalist (hyperostosing meningioma) approaches. He explains that visualization during surgery means using image guided navigation to accomplish several goals: Localizing lesions and orienting in the case of small openings as well as anatomy that’s been obscured by tumor, choosing the correct approach both before and during surgery, assessing progress intraoperatively, and minimizing exposure, pain for the patient, as well as surgical time. Dr. Bloch also discusses the importance of intraoperative imaging as well as Adaptive Hybrid Surgery to assess the extent of resection. Finally, he covers the importance of automated registration through intraoperative imaging to achieve accurate results: “The quality of navigation is only as good as the registration”.