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Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
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Automated objective surgical planning for lateral skull base tumors.
A E Rajesh1, J T Rubinstein2, M Ferreira3
1University of Washington School of Medicine, Seattle, WA, USA.
International Journal of Computer Assisted Radiology and Surgery
|January 28, 2022
Summary
An automated planning algorithm helps select the best surgical approach for vestibular schwannomas, aiming to preserve hearing and minimize complications in lateral skull base surgery.
Area of Science:
- Neurosurgery
- Medical Imaging
- Computational Anatomy
Background:
- Lateral skull base surgery presents challenges due to critical anatomical structures.
- Pre-operative planning can optimize surgical approaches and reduce patient morbidity.
Purpose of the Study:
- To develop an automated surgical approach planning algorithm for vestibular schwannomas.
- To optimize hearing preservation in internal auditory canal surgeries.
- To minimize surgical morbidity through computed approach selection.
Main Methods:
- An algorithm was developed to select between middle cranial fossa and retrosigmoid approaches.
- Patient-specific anatomy was segmented.
- A cost function was used to minimize potential surgical morbidity.
Main Results:
- The study included 9 patients undergoing hearing preservation surgery for vestibular schwannoma.
- The algorithm's favored approach matched the performed surgery in 6 out of 9 cases.
- Middle cranial fossa approach was used in 5 patients, retrosigmoid in 4.
Conclusions:
- A method for computing surgical path morbidity costs was established.
- Computed pre-operative planning can aid surgical decision-making.
- This approach may improve clinical outcomes and aid in trainee education.
