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Does High-Definition 3-Dimensional Imaging Improve Orientation During Endoscopic Transsphenoidal Surgery? A
Alexander S G Micko1, Anna Cho2, Simon Heck2
1Department of Neurosurgery, Medical University of Graz, Styria, Austria.
Operative Neurosurgery (Hagerstown, Md.)
|January 26, 2023
Summary
Three-dimensional (3D) high-definition (HD) endoscopes significantly improve landmark identification accuracy in the sphenoid sinus compared to 2D HD endoscopes. This enhanced spatial orientation may increase safety in endoscopic skull base surgery.
Area of Science:
- Neurosurgery
- Otolaryngology
- Medical Imaging
Background:
- Endoscopic visualization is standard for transsphenoidal resection of sellar lesions.
- Traditional 2-dimensional (2D) endoscopes lack depth perception.
- 3-dimensional (3D) endoscopes offer stereoscopic views to improve depth perception.
Purpose of the Study:
- To compare the spatial orientation capabilities of high-definition (HD) 2D versus 3D HD endoscopes within the sphenoid sinus.
Main Methods:
- A prospective study involving 21 patients (2021-2022).
- Eleven standardized anatomical landmarks were identified using a navigation probe.
- Visualization was performed using either 2D HD or 3D HD endoscopes.
Main Results:
- 3D HD endoscopes demonstrated statistically significant higher accuracy in landmark identification (median deviation 4.2 mm vs 5.2 mm, P < .001).
- Specific landmarks like the tuberculum sellae, anterior point of the sella, and clivus indentation showed improved accuracy with 3D HD.
- Anatomical variations did not impact landmark identification accuracy.
Conclusions:
- Stereoscopic 3D HD endoscopy enhances intraoperative orientation via improved depth perception in the sphenoid sinus.
- This technology may improve the safety of endoscopic skull base procedures, particularly in complex cases.
