A Low-Cost Mobile-Based Augmented Reality Neuronavigation System for Retrosigmoid Craniotomy

The correct positioning of the transverse-sigmoid sinus junction (TSSJ) during retrosigmoid craniotomy (RC) is crucial for enhancing surgical efficiency and preventing complications. An augmented reality technology may provide low-cost guidance for the TSSJ position. The authors aimed to investigate the clinical application of a self-developed mobile augmented reality navigation system (MARNS) for TSSJ positioning during RC and present their findings.

This observational research enrolled patients who underwent RC at Fujian Provincial Hospital from May 2023 to June 2023. All patients had their TSSJs located by MARNS. The surgical incision and skull "keyhole" for drilling were determined separately based on the projections of TSSJ on the 3-dimensional model displayed by MARNS. This method was assessed using matching error, positioning time, integrity of the bone flap, incidence of transversal sigmoid sinus injury, and other complications.

Seven patients diagnosed with acoustic neuroma, trigeminal neuralgia, and hemifacial spasm were enrolled in this study. The MARNS system exhibited a matching error with an average magnitude of 2.88 ± 0.69 mm. The positioning procedure necessitated an average duration of 279.71 ± 27.29 seconds. In every instance, the inner edge of the TSSJ was precisely identified and exposed while the bone flap was successfully formed and maintained an average integrity of 86.7%.

This study demonstrated the efficacy of MARNS in the precise placement of the TSSJ during RC procedures. It offers advantages for convenience, cost-effectiveness, and reliability for neurosurgical navigation.