Pre-Operative Planning of a DCR Surgery Using Virtual Reality

Area of Science:

• Ophthalmology and Otolaryngology
• Medical Imaging and Visualization
• Surgical Anatomy Education

Background:

• Accurate interpretation of preoperative Computed Tomography (CT) scans is crucial for Dacryocystorhinostomy (DCR) surgery.
• Virtual Reality (VR) offers potential for immersive visualization of complex anatomical structures.
• Evaluating the efficacy of novel VR tools in surgical planning is essential.

Purpose of the Study:

• To assess a novel Virtual Reality (VR) tool designed to enhance understanding of nasal anatomy.
• To evaluate the tool's impact on the interpretation of preoperative CT scans for DCR surgery.
• To compare the diagnostic accuracy of ENT surgeons and ophthalmologists using the VR tool.

Main Methods:

• Preoperative orbit CT scans (DICOM) were processed for 3D anatomical model preparation using specialized software.
• Segmentation included skull, lacrimal sac, nasal septum, and turbinates; the 3D model was visualized with a VR headset.
• Ten cases were evaluated by six surgeons (ENT and oculoplastic, senior and resident) using the VR tool.

Main Results:

• ENT surgeons correctly identified the side of pathology in 73.3% of cases, significantly better than ophthalmologists (43.3%, p=0.018).
• ENT surgeons correctly identified septum deviation in 72.8% of cases, compared to 47.2% for ophthalmologists (p=0.094).
• No significant difference in diagnostic accuracy was observed between consultants and residents, and the VR tool did not improve overall interpretation accuracy.

Conclusions:

• ENT surgeons demonstrated superior interpretation of CT scans compared to ophthalmologists, and consultants outperformed residents.
• The current VR system did not enhance the interpretation of preoperative CT scans for DCR surgery.
• Further research is needed to develop VR systems that effectively aid in the interpretation of CT scans for DCR surgery planning and execution.