Six Years of Neuro-Navigation Assisted Brain Tumor Surgery North Central Nigeria: Progress and Challenges

Abstract

Introduction: Cranial operations in general have been historically driven by sound anatomical navigation with tremendous success. However, due to the unending desire for perfection, computerized neuro-navigation-assisted cranial surgery has found global usefulness, especially in neuro-oncological services. Our initial experience and challenges with this technology was already published three years ago but it becomes expedient for an update. Aims and Objectives: To report a six-year experience with computerized neuro-navigation assistance in our neuro-oncology surgeries and services. Methodology: Retrospective review of all consecutive cases involving computer-assisted neuro-navigation diagnostic and resective brain tumor operation over a six-year period (January 2016-December 2021). Main study parameters: Clinical diagnostic procedures, operations, histological diagnosis, adjuvant treatments. Data were analyzed using simple descriptive statistics, and results were presented accordingly. Results: Total number of cases 111, Males 70 and Females 41 (M: F = 1.7:1). Age ranges from 8 months to 80 years. The commonest presentation was headache, nausea, and vomiting. Pre-op diagnosis: Intra axial tumors 70/111 (63%), Extra axial tumors 41/111 (36%). Operations: Resection/Debulking of tumor 86/111 (77,4%), with complete EOR of 65/86 (75%). Diagnostic Biopsy 68/111 (61%) with target precision of 100%. Common Histology were Gliomas 50/111 (45%), Meningiomas 41/111 (36.9%), and Metastatic 15/111 (13.5%). Adjuvant treatments and follow-ups were advised accordingly. Conclusions: With computerized neuro-navigation assistance, a wider spectrum of brain tumors were more confidently operated, and adjuvant treatments were easily deployed in line with a precise histological diagnosis for improved neuro-oncology services. But this success was at a huge cost of adopting measures to overcome some inevitable challenges.