Impact of intraoperative ultrasound guidance on resection of nondominant frontal lobe tumors: Effects on extent of resection, neurological status, and postoperative seizures

Background: Achieving an optimal balance between the maximal possible extent of resection and preservation of neurological function remains a major challenge in neuro-oncology, particularly in tumors located within functionally eloquent areas. Intraoperative ultrasound (IOUS) provides real-time visualization, potentially enhancing surgical precision and improving clinical outcomes. Methods: A retrospective comparative analysis was conducted on 90 patients, divided into two groups: IOUS ( n = 45; resection under ultrasound guidance) and control ( n = 45; standard resection without navigation). Evaluated outcomes included the extent of resection based on magnetic resonance imaging, postoperative motor deficit (assessed by the Medical Research Council scale), and occurrence of early (≤30 days) and late (>30 days) de novo seizures. Results: The extent of resection was comparable between groups (94.5% vs. 91.8%, P = 0.09). New postoperative motor deficits were less frequent in the IOUS group (15.6% vs. 31.1%, P = 0.07). The incidence of early de novo seizures was significantly lower in the IOUS group (8.9% vs. 28.9%, P = 0.02). Conclusion: The use of IOUS in the resection of tumors of the right nondominant frontal lobe enables a high extent of resection, shows a trend toward better preservation of neurological function, and significantly reduces the risk of early postoperative seizures.