Abstract
BackgroundIt is difficult for neurosurgeons to perceive the complex three-dimensional anatomical relationships in the sellar region.MethodsTo investigate the value of using a virtual reality system for planning resection of sellar region tumors. The study included 60 patients with sellar tumors. All patients underwent computed tomography angiography, MRI-T1W1, and contrast enhanced MRI-T1W1 image sequence scanning. The CT and MRI scanning data were collected and then imported into a Dextroscope imaging workstation, a virtual reality system that allows structures to be viewed stereoscopically. During preoperative assessment, typical images for each patient were chosen and printed out for use by the surgeons as references during surgery.ResultsAll sellar tumor models clearly displayed bone, the internal carotid artery, circle of Willis and its branches, the optic nerve and chiasm, ventricular system, tumor, brain, soft tissue and adjacent structures. Depending on the location of the tumors, we simulated the transmononasal sphenoid sinus approach, transpterional approach, and other approaches. Eleven surgeons who used virtual reality models completed a survey questionnaire. Nine of the participants said that the virtual reality images were superior to other images but that other images needed to be used in combination with the virtual reality images.ConclusionsThe three-dimensional virtual reality models were helpful for individualized planning of surgery in the sellar region. Virtual reality appears to be promising as a valuable tool for sellar region surgery in the future.
Highlights
It is difficult for neurosurgeons to perceive the complex three-dimensional anatomical relationships in the sellar region
The three-dimensional virtual reality models were helpful for individualized planning of surgery in the sellar region
Application of the digital sellar tumor model in surgical planning The images of the planes containing the surgical approach-related anatomical structures were extracted from the model and displayed simultaneously in the Virtual reality (VR) environment
Summary
It is difficult for neurosurgeons to perceive the complex three-dimensional anatomical relationships in the sellar region. Aydin et al used cadavers to describe the anatomical features and variations of the structures in this region such as the sella turcica, sphenoid ostia, sphenoid sinus and septae, optic protuberance, and carotid protuberance [2]. They described the various supra and parasellar neurovascular structures. The anatomical studies on sellar tumors and surrounding structures are mainly based on cadaver specimens and two-dimensional cross-sectional images [3]. There is a need for a more suitable tool and method to provide a basis for understanding sellar region anatomy
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