Stereotaxy for surgical navigation in orbital surgery.

PURPOSE: Image guidance has been used in neurosurgery with great success. The authors illustrate the use of stereotaxy and neuronavigation in the surgical management of a cranio-orbital tumor and for orbital decompresson in thyroid orbitopathy.

METHODS: Stereotactic image guidance was used in the surgical management of 2 patients, one with a large left sphenoid wing meningioma causing proptosis and visual loss from orbital extension, and the other with disfiguring proptosis due to thyroid eye disease. Virtual reality simulation was used preoperatively in the first patient to visualize surgical corridors of approach to the tumor.

RESULTS: The patients underwent successful orbital surgery aided by intraoperative neuronavigation. The sphenoidal wing meningioma was removed completely with no damage to adjacent orbital and intracranial tissues, and orbital decompression was successfully performed with good cosmetic improvement.

CONCLUSION: Image-guided neuronavigation in our cases allowed for safe and precise surgery, with avoidance of complications.