Intraoperative use of heads-up display in skull base surgery.

Laura Salgado-Lopez,Holly Oemke,Stavros Matsoukas,Raj Shrivastava,Joshua Bederson,Rui Feng,J Mocco

doi:10.3171/2021.10.focvid21177

Laura Salgado-Lopez, Holly Oemke + Show 5 more

Open Access

https://doi.org/10.3171/2021.10.focvid21177

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Journal: Neurosurgical focus: Video	Publication Date: Jan 1, 2022
License type: CC BY 4.0

Affiliation: Mount Sinai Hospital

Abstract

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

Highlights

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
We can see in close detail how the tumor was encasing the internal carotid artery terminus, the origin of the anterior and middle cerebral arteries, as well as the posterior communicating and anterior choroidal arteries
The segmented neurovascular objects can be highlighted in specific colors; here, among others, we have segmented the tumor in purple, the internal carotid and middle cerebral arteries in pink, the posterior communicating artery in blue, optic nerves in yellow, and the brainstem in green

Summary

Introduction

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. Note the fetal origin of the right posterior cerebral artery. Three-dimensional simulation allows neurosurgeons in training to explore the different operative angles, as well as to plan the bone opening while using the virtual reality goggles.[2,3] Here we can see in close detail how the tumor was encasing the internal carotid artery terminus, the origin of the anterior and middle cerebral arteries, as well as the posterior communicating and anterior choroidal arteries.

Results

Conclusion