A technology the Taipei Veterans General Hospital describes as a “GPS navigation system for brain surgery,” called intraoperative neurophysiological monitoring (IONM), offers a new and safer option for patients suffering from brain tumors, the hospital said yesterday.
The technique helps surgeons locate and avoid the functional areas of the cerebral cortex and the spinal cord during operations, or issues warnings to the surgeons about any adverse changes to the neural functions during surgery, which would then allow a change of operative strategy or a termination of the surgery, the hospital said.
“A lot of patients with brain malignancies decide not to undergo brain surgery for fear of paralysis or becoming a vegetable,” neurosurgeon Sanford Hsu (許秉權) said.
These patients and those with brain tumors in areas that had been deemed to be inoperable now have the option to undergo the surgery with IONM for tumor removal due to better precision and the minimization of potential damage to the nervous system that in the past sometimes led to inadvertent postoperative complications and deaths, Hsu said.
The IONM team at the hospital was established in 2010, consisting of neurosurgeons, neurophysiologists, neuroanesthesiologists and professionals in neurological rehabilitation.
IONM has been used utilized in some developed countries for years for surgeries on spinal and cerebral blood vessels, the removal of brain tumors in the cerebral functional areas and cranial base tumors, and operations for hemifacial spasm or epilepsy, the hospital said.
The hospital said it is one of the few hospitals in the world that have achieved a median survival time for fourth-grade glioma patients of 22 months and an average relapse-free time of 15 months.
The hospital has also performed 20 surgeries over a period of two years dealing with insular cortex tumors, which has been considered one of the most dangerous operations, with none of the 20 patients suffering from permanent disability-causing complications or deaths.
Brain tumors located in cerebral functional areas, such as motor cortex areas and the language areas, used to be only partly removed for fear of postoperative complications, but with the assistance of IONM, along with awake craniotomy, the removal of entire tumors is possible and the recovery of the patients is improved, Hsu said.
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