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Augmented Reality for Retrosigmoid Craniotomy Planning.

Christoph Leuze1, Caio A Neves2,3, Alejandro M Gomez4,5

  • 1Department of Radiology, Stanford School of Medicine, Stanford, United States.

Journal of Neurological Surgery. Part B, Skull Base
|July 14, 2022
PubMed
Summary
This summary is machine-generated.

Augmented reality (AR) enhances surgical planning by projecting medical imaging onto patients, guiding procedures like retrosigmoid craniotomy. This AR application demonstrated accurate guidance for bone removal, improving surgical precision.

Keywords:
acoustic neuromaaugmented realitycraniotomymagicleapretrosigmoid approachschwannoma

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Area of Science:

  • Neurosurgery
  • Medical Imaging
  • Augmented Reality

Background:

  • Traditional 2D displays limit anatomical visualization in surgery.
  • Augmented reality (AR) offers potential for improved intraoperative guidance.
  • Retrosigmoid craniotomy is a key approach for posterior fossa access.

Purpose of the Study:

  • To present and evaluate a surgical AR application for planning retrosigmoid craniotomy.
  • To assess the accuracy of AR-guided cortical bone removal compared to traditional methods.
  • To determine the feasibility of AR in guiding surgical approaches to the internal auditory canal.

Main Methods:

  • Two surgeons performed 14 retrosigmoid approaches on cadaver heads using an AR system.
  • Computed tomography (CT)-derived virtual renderings were aligned with cadaveric anatomy via a see-through AR display.
  • Post-procedure CT scans evaluated the accuracy of osteotomy margins relative to dural sinuses.

Main Results:

  • The AR application successfully guided the retrosigmoid approach in all 14 cases.
  • Mean margins between osteotomy borders and dural sinuses were low (0.6 ± 4.7 mm and 3.7 ± 2.3 mm).
  • The intended surgical approach to the internal auditory canal was achieved in all procedures.

Conclusions:

  • The developed AR system provides accurate guidance for retrosigmoid craniotomy planning.
  • AR application shows potential as a valuable tool for skull-base surgery planning and execution.
  • The system offers a precise alternative to surface landmarks and conventional navigation systems.