Augmented Reality Application for Aiding Tumor Resection in Skull-Base Surgery

2019 ◽  
Author(s):  
Niveditha Kalavakonda ◽  
Laligam Sekhar ◽  
Blake Hannaford
Keyword(s):  
Augmented Reality ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Tumor Resection ◽  
Augmented Reality Application

scholarly journals First experience with augmented reality neuronavigation in endoscopic assisted midline skull base pathologies in children

2021 ◽  
Author(s):  
Valentina Pennacchietti ◽  
Katharina Stoelzel ◽  
Anna Tietze ◽  
Erwin Lankes ◽  
Andreas Schaumann ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Morphological Variability ◽  
Case Series ◽  
Relevant Information ◽  
Navigation Systems ◽  
Postoperative Mri ◽  
The Mean ◽  
Clinical Conditions

Abstract Introduction Endoscopic skull base approaches are broadly used in modern neurosurgery. The support of neuronavigation can help to effectively target the lesion avoiding complications. In children, endoscopic-assisted skull base surgery in combination with navigation systems becomes even more important because of the morphological variability and rare diseases affecting the sellar and parasellar regions. This paper aims to analyze our first experience on augmented reality navigation in endoscopic skull base surgery in a pediatric case series. Patients and methods A retrospective review identified seventeen endoscopic-assisted endonasal or transoral procedures performed in an interdisciplinary setting in a period between October 2011 and May 2020. In all the cases, the surgical target was a lesion in the sellar or parasellar region. Clinical conditions, MRI appearance, intraoperative conditions, postoperative MRI, possible complications, and outcomes were analyzed. Results The mean age of our patients was 14.5 ± 2.4 years. The diagnosis varied, but craniopharyngiomas (31.2%) were mostly represented. AR navigation was experienced to be very helpful for effectively targeting the lesion and defining the intraoperative extension of the pathology. In 65% of the oncologic cases, a radical removal was proven in postoperative MRI. The mean follow-up was 89 ± 79 months. There were no deaths in our series. No long-term complications were registered; two cerebrospinal fluid (CSF) fistulas and a secondary abscess required further surgery. Conclusion The implementation of augmented reality to endoscopic-assisted neuronavigated procedures within the skull base was feasible and did provide relevant information directly in the endoscopic field of view and was experienced to be useful in the pediatric cases, where anatomical variability and rarity of the pathologies make surgery more challenging.

scholarly journals Preservation of nasal turbinates in endoscopic, anterior skull base surgery—yes, we can!

2021 ◽  
Author(s):  
Axel Wolf ◽  
Alexandros Andrianakis ◽  
Peter Valentin Tomazic ◽  
Michael Mokry ◽  
Georg Clarici ◽  
...  
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Tumor Resection ◽  
Tumor Location ◽  
Anterior Skull Base ◽  
Tumor Diameter ◽  
Tumor Type ◽  
Preoperative Information ◽  
Medical University ◽  
Significant Factors

Abstract Objective To evaluate the frequency, type and indications of nasal turbinate (NT) resection during endoscopic, anterior skull base surgery and to analyze factors that may have an impact on the need of NT removal. Methods In this retrospective cohort study, 306 subjects (150 males and 156 females, mean age 55.4 ± 15.3 years) who underwent multidisciplinary, transnasal, endoscopic tumor surgery of the anterior skull base using 4-handed techniques between 2011 and 2019 at the Department of Otorhinolaryngology, Medical University of Graz, were included. Results In the majority of interventions (n = 281/306; 91.8%), all NT were preserved. Significant factors influencing the need of NT resections turned out to be type of endoscopic approach (p < 0.001; V = 0.304), sagittal (p = 0.003; d = 0.481) and transversal (p = 0.017; d = 0.533) tumor diameter, tumor type (p < 0.001; V = 0.355) and tumor location (p < 0.001; V = 0.324). Conclusions NT can be preserved in the majority of patients undergoing tumor resection in anterior, transnasal, skullbase surgery and routine resection of NT should be avoided. Variables that have an impact on the need of NT resections are types of endoscopic approaches, sagittal and transversal tumor extension and tumor type. These factors should be considered in planning of surgery and preoperative information of patients.

Transtemporal Skull Base Surgery

1995 ◽  
Vol 112 (5) ◽  
pp. P119-P119
Author(s):  
C. Gary Jackson ◽  
James L. Netterville
Keyword(s):  
Functional Outcome ◽  
Skull Base ◽  
Cranial Nerve ◽  
Skull Base Surgery ◽  
Tumor Resection ◽  
Operative Management ◽  
Educational Objectives ◽  
Defect Reconstruction ◽  
Lateral Skull Base

Educational objectives: To become familiar with diagnostic and operative management principles for lateral skull-base disease and its ICE, emphasizing not only multi-disciplinary tumor resection but functional outcome and to be familiar with concepts of defect reconstruction and cranial nerve rehabilitation that maximize postresection functional outcome.

scholarly journals Intraoperative use of heads-up display in skull base surgery

2022 ◽  
Vol 6 (1) ◽  
pp. V2
Keyword(s):  
Virtual Reality ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Tumor Resection ◽  
Neurological Deficits ◽  
Neurophysiological Monitoring ◽  
Subtotal Resection ◽  
Reduce Blood Loss ◽  
Tumor Embolization ◽  
Anterior Choroidal

In this video, the authors highlight the applications of virtual reality and heads-up display in skull base surgery by presenting the case of a 45-year-old woman with an incidental large clinoid meningioma extending into the posterior fossa. The patient underwent preoperative endovascular tumor embolization to facilitate tumor resection and reduce blood loss, followed by a right pterional craniotomy. The use of intraoperative Doppler, intraoperative neurophysiological monitoring, and endoscope-assisted microsurgery is also featured. A subtotal resection was planned given tumor encasement of the posterior communicating and anterior choroidal arteries. No new neurological deficits were noted after the surgical procedure. The video can be found here: https://stream.cadmore.media/r10.3171/2021.10.FOCVID21177

The utility of augmented reality in lateral skull base surgery: A preliminary report

2021 ◽  
Vol 42 (4) ◽  
pp. 102942
Author(s):  
Zachary G. Schwam ◽  
Vivian F. Kaul ◽  
Daniel D. Bu ◽  
Alfred-Marc Calo Iloreta ◽  
Joshua B. Bederson ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Skull Base ◽  
Preliminary Report ◽  
Skull Base Surgery ◽  
Lateral Skull Base

scholarly journals Endoscopic transsphenoidal resection of craniopharyngioma

2021 ◽  
Vol 50 (2) ◽  
pp. 152
Author(s):  
Esmaralda Nurul Amany
Keyword(s):  
Skull Base ◽  
Endoscopic Surgery ◽  
Skull Base Surgery ◽  
Tumor Resection ◽  
Endoscopic Approach ◽  
Cochrane Library ◽  
Morbidity Rate ◽  
Literature Study ◽  
Endoscopic Skull Base Surgery ◽  
Microscopic Surgery

ABSTRACTBackground: Endoscopic surgery techniques had been advancing in this last two decades. Transsphenoidal approach endoscopic surgery to the skull base provides better visualization of the operation field compared to microscopic surgery, and also brought lower morbidity than other techniques. Purpose: To report a transsphenoidal endoscopic skull base surgery for craniopharyngioma resection. Case Report: A case of craniopharyngioma in a 47-year-old man. The tumor resection was performed with transsphenoidal endoscopic approach, in collaboration with a neurosurgeon. Clinical Question: Is transsphenoidal endoscopic skull base surgery approach, the appropriate surgical procedure for craniopharyngioma management? Review Method: Evidence based literature study of skull base surgery with transsphenoidal endoscopic approach in craniopharyngioma through database Cochrane library, Pubmed Medline, and hand searching. Result: Skull base surgery with transsphenoidal endoscopic approach was minimally invasive with maximally invasion compared to transcranial surgery, and  also provided better view, and could reduce complication rate. Conclusion: Skull base surgery with transsphenoidal endoscopic approach offers more advantage in skull base lesion management compared to other techniques. Collaboration between neurosurgeon and otorhinolaryngologist using this technique could reduce complication and morbidity rate.  ABSTRAKLatar belakang: Teknik operasi endoskopi mengalami perkembangan pesat dalam dua dekade terakhir. Bedah basis kranii dengan pendekatan endoskopi transfenoid memberikan kualitas visualisasi lapang pandang operasi lebih baik dibanding menggunakan mikroskop, dan juga mengakibatkan morbiditas lebih rendah dibanding teknik lainnya. Tujuan: Melaporkan keberhasilan bedah basis kranii dengan pendekatan endoskopi transfenoid pada kraniofaringioma. Laporan kasus: Seorang laki-laki 47 tahun dengan diagnosis kraniofaringioma yang dilakukan tindakan reseksi tumor dengan pendekatan endoskopi transfenoid berkolaborasi dengan ahli bedah saraf. Pertanyaan Klinis: Apakah bedah basis kranii dengan pendekatan endoskopi transfenoid merupakan teknik operasi yang tepat untuk tatalaksana kraniofaringioma? Telaah literatur: Telaah literatur berbasis bukti mengenai bedah basis kranii dengan pendekatan endoskopi transfenoid pada kraniofaringioma melalui database Cochrane library, Pubmed Medline, dan pencarian manual. Hasil: Bedah basis kranii dengan pendekatan endoskopi transfenoid memberikan akses minimal dengan invasi maksimal, visualisasi lebih baik, dan dapat menurunkan angka komplikasi. Kesimpulan: Bedah basis kranii dengan pendekatan endoskopi transfenoid merupakan teknik operasi lesi basis kranii yang lebih unggul dibandingkan teknik lainnya. Kolaborasi antara ahli bedah saraf dan THT dapat mengurangi angka komplikasi dan morbiditas tindakan ini.

Augmented reality-assisted skull base surgery

2014 ◽  
Vol 60 (6) ◽  
pp. 304-306 ◽  
Author(s):  
I. Cabrilo ◽  
A. Sarrafzadeh ◽  
P. Bijlenga ◽  
B.N. Landis ◽  
K. Schaller
Keyword(s):  
Augmented Reality ◽  
Skull Base ◽  
Skull Base Surgery

Expanded endoscopic endonasal transcribriform approach for resection of anterior skull base olfactory schwannoma

2012 ◽  
Vol 32 (Suppl1) ◽  
pp. E3 ◽  
Author(s):  
James K. Liu ◽  
Jean Anderson Eloy
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Tumor Resection ◽  
Cranial Base ◽  
Anterior Skull Base ◽  
Endoscopic Endonasal ◽  
Olfactory Groove ◽  
Anterior Cranial Base ◽  
Ventral Skull Base ◽  
Brain Retraction

Anterior skull base (ASB) schwannomas are extremely rare and can often mimic other pathologies involving the ASB such as olfactory groove meningiomas, hemangiopericytomas, esthesioneuroblastomas, and other malignant ASB tumors. The mainstay of treatment for these lesions is gross-total resection. Traditionally, resection for tumors in this location is performed through a bifrontal transbasal approach that can involve some degree of brain retraction or manipulation for tumor exposure. With the recent advances in endoscopic skull base surgery, various ASB tumors can be resected successfully using an expanded endoscopic endonasal transcribriform approach through a “keyhole craniectomy” in the ventral skull base. This approach represents the most direct route to the anterior cranial base without any brain retraction. Tumor involving the paranasal sinuses, medial orbits, and cribriform plate can be readily resected. In this video atlas report, the authors demonstrate their step-by-step techniques for resection of an ASB olfactory schwannoma using a purely endoscopic endonasal transcribriform approach. They describe and illustrate the operative nuances and surgical pearls to safely and efficiently perform the approach, tumor resection, and multilayered reconstruction of the cranial base defect. The video can be found here: http://youtu.be/NLtOGfKWC6U.

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