Frame-based, stereotactic craniotomy localization is the most accurate method having the lowest rate of postoperative neurological deficits and complications 1).

Although the method is the most accurate, it is time consuming, and the stereotactic frame may restrict the operating field if using microsurgical approaches. Procedures along the skull base or midline may be difficult to manage. 2) Compared with frame-based systems, frameless neuronavigation allows more flexibility during microsurgical procedures. Introduced into neurosurgical routine in the late 1980s and early 1990s, several advantages of this technology have been pointed out 3) 4).


1)
Spivak C.J., Pirouzmand F. Comparison of the reliability of brain lesion localization when using traditional and stereotactic image-guided techniques: A prospective study. J. Neurosurg. 2005;103:424–427.
2)
Oishi M., Fukuda M., Ishida G., Saito A., Hiraishi T., Fujii Y. Presurgical simulation with advanced 3-dimensional multifusion volumetric imaging in patients with skull base tumors. Neurosurgery. 2011;68:188–199.
3)
Schroeder H.W., Wagner W., Tschiltschke W., Gaab M.R. Frameless neuronavigation in intracranial endoscopic neurosurgery. J. Neurosurg. 2001;94:72–79
4)
Woerdeman P.A., Willems P.W., Noordmans H.J., Tulleken C.A., van der Sprenkel J.W. Application accuracy in frameless image-guided neurosurgery: A comparison study of three patient-to-image registration methods. J. Neurosurg. 2007;106:1012–1016.
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