Intraoperative use of heads-up display in skull base surgery

Area of Science:

• Neurosurgery
• Medical Technology
• Surgical Oncology

Background:

• Skull base meningiomas present complex surgical challenges.
• Advanced imaging and surgical techniques are crucial for managing these tumors.
• Virtual reality (VR) and heads-up display (HUD) offer potential benefits in complex neurosurgical procedures.

Purpose of the Study:

• To highlight the application of virtual reality and heads-up display in skull base surgery.
• To present a case study of a large clinoid meningioma managed with advanced surgical technologies.
• To demonstrate preoperative and intraoperative techniques for complex tumor resection.

Main Methods:

• Case presentation of a 45-year-old woman with a large clinoid meningioma.
• Preoperative endovascular tumor embolization to reduce blood loss.
• Right pterional craniotomy utilizing intraoperative Doppler, neurophysiological monitoring, and endoscope-assisted microsurgery.
• Virtual reality and heads-up display integration during the surgical procedure.

Main Results:

• Successful subtotal resection of the clinoid meningioma was achieved.
• Tumor encasement of critical arteries (posterior communicating and anterior choroidal) necessitated a planned subtotal resection.
• No new neurological deficits were observed postoperatively.
• Demonstrated feasibility of VR and HUD in complex skull base surgery.

Conclusions:

• Virtual reality and heads-up display are valuable tools in complex skull base surgery.
• Advanced multimodal techniques, including embolization and neurophysiological monitoring, are essential for safe resection of challenging meningiomas.
• Careful surgical planning and execution allow for safe subtotal resection in cases of tumor encasement of vital structures.