USE OF AN OPEN STEREOTAXIC RING FOR NEUROSURGICAL PROCEDURES

We describe an open ring as a new design to the Zamorano-Dujovny (Z-D) stereotactic unit. The titanium base ring has an opening of 45 degree s that can be located in any chosen position. Imaging studies such as computed tomography, X-ray, positron emission tomography, digital angi ography, and digital substraction angiography can be performed with th e open stereotactic ring for multimodality image localization. Preoper atively and intraoperatively, this open design provides the anesthesio logist with an unobstructed pathway for airway management. During the surgical procedure, it facilitates approach to any intracranial lesion , including orbitozygomatic, combined supra-infratentorial, and others . During awake craniotomies it not only allows for easy airway managem ent, but also provides good access to the patient's face for intraoper ative evaluation of speech and visual functions. Accuracy and reliabil ity of this unit were similar to results obtained with the original ci rcular ring. This system can be used in conventional stereotaxis with the Z-D are, as well as a reference for intraoperative registration wi th any digitizer system. The open stereotactic unit is a relatively in expensive, reliable, and easy-to-use solution for resections using con ventional stereotaxis or interactive image guidance in any intracrania l site.