A smartphone-based augmented reality technique for preoperative planning of chronic subdural hematoma

Chronic subdural hematoma is one of the most common pathologies in neurosurgery and represents one of the first surgical challenges for residents and surgeons in their early years of experience, particularly when the hematoma lacks a typical hemispheric distribution. Our study presents an innovative and low-cost smartphone-based augmented reality (AR) technique designed to facilitate the preoperative planning of chronic subdural hematomas.

Twenty patients with non-fully hemispheric subdural hematomas operated using a smartphone-based AR platform (AR-based planning, AR-b) were included in our study. Before the skin incision, the site and extent of the surgical access were verified by a second surgeon, whose planning was based solely on 2D computed tomography images (2D-b). Data regarding spatial discrepancies and length differences between the two planning were collected and analyzed with a paired t-test with a significance level of 0.05.

No discrepancies >1 cm were found between the two methods. We found a significant difference between the length of the two planning phases (AR-b: 8' ± 1,9 vs. 2D-b: 4,1' ± 1,4). Nevertheless, concerning the overall surgical duration, no marked difference was found between the total length of the procedures performed with AR-b and similar procedures planned with 2D-b.

Due to its lack of additional costs and effective precision, our technique represents a valuable aid for surgeons in training or in their early years of experience in the presurgical planning of chronic subdural hematoma.