Augmented Reality-Assisted Craniotomy for Parasagittal and Convexity En Plaque Meningiomas and Custom-Made Cranio-Plasty: A Preliminary Laboratory Report.

Abstract

BACKGROUND:

This report discusses the utility of a wearable augmented reality platform in neurosurgery for parasagittal and convexity en plaque meningiomas with bone flap removal and custom-made cranioplasty.

METHODS:

A real patient with en plaque cranial vault meningioma with diffuse and extensive dural involvement, extracranial extension into the calvarium, and homogeneous contrast enhancement on gadolinium-enhanced T1-weighted MRI, was selected for this case study. A patient-specific manikin was designed starting with the segmentation of the patient's preoperative MRI images to simulate a craniotomy procedure. Surgical planning was performed according to the segmented anatomy, and customized bone flaps were designed accordingly. During the surgical simulation stage, the VOSTARS head-mounted display was used to accurately display the planned craniotomy trajectory over the manikin skull. The precision of the craniotomy was assessed based on the evaluation of previously prepared custom-made bone flaps.

RESULTS:

A bone flap with a radius 0.5 mm smaller than the radius of an ideal craniotomy fitted perfectly over the performed craniotomy, demonstrating an error of less than ±1 mm in the task execution. The results of this laboratory-based experiment suggest that the proposed augmented reality platform helps in simulating convexity en plaque meningioma resection and custom-made cranioplasty, as carefully planned in the preoperative phase.

CONCLUSIONS:

Augmented reality head-mounted displays have the potential to be a useful adjunct in tumor surgical resection, cranial vault lesion craniotomy and also skull base surgery, but more study with large series is needed.

• Authors: Nicola Montemurro, Sara Condino, Nadia Cattari, Renzo D'Amato, Vincenzo Ferrari, Fabrizio Cutolo
• Journal: International journal of environmental research and public health (Int J Environ Res Public Health) Vol. 18 Issue 19 (09 22 2021) ISSN: 1660-4601 [Electronic] Switzerland
• PMID: 34639256 (Publication Type: Journal Article)

Topics

• Augmented Reality
• Craniotomy
• Humans
• Laboratories
• Meningeal Neoplasms (diagnostic imaging, surgery)
• Meningioma (diagnostic imaging, surgery)