Narrative review of patient-specific 3D visualization and reality technologies in skull base neurosurgery: enhancements in surgical training, planning, and navigation

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2024-07-16 DOI:10.3389/fsurg.2024.1427844

İlkay Işıkay, Efecan Çekiç, Baylar Baylarov, Osman Tunç, Ş. Hanalioğlu

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引用次数: 0

Abstract

Recent advances in medical imaging, computer vision, 3-dimensional (3D) modeling, and artificial intelligence (AI) integrated technologies paved the way for generating patient-specific, realistic 3D visualization of pathological anatomy in neurosurgical conditions. Immersive surgical simulations through augmented reality (AR), virtual reality (VR), mixed reality (MxR), extended reality (XR), and 3D printing applications further increased their utilization in current surgical practice and training. This narrative review investigates state-of-the-art studies, the limitations of these technologies, and future directions for them in the field of skull base surgery. We begin with a methodology summary to create accurate 3D models customized for each patient by combining several imaging modalities. Then, we explore how these models are employed in surgical planning simulations and real-time navigation systems in surgical procedures involving the anterior, middle, and posterior cranial skull bases, including endoscopic and open microsurgical operations. We also evaluate their influence on surgical decision-making, performance, and education. Accumulating evidence demonstrates that these technologies can enhance the visibility of the neuroanatomical structures situated at the cranial base and assist surgeons in preoperative planning and intraoperative navigation, thus showing great potential to improve surgical results and reduce complications. Maximum effectiveness can be achieved in approach selection, patient positioning, craniotomy placement, anti-target avoidance, and comprehension of spatial interrelationships of neurovascular structures. Finally, we present the obstacles and possible future paths for the broader implementation of these groundbreaking methods in neurosurgery, highlighting the importance of ongoing technological advancements and interdisciplinary collaboration to improve the accuracy and usefulness of 3D visualization and reality technologies in skull base surgeries.

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颅底神经外科患者专用三维可视化和现实技术综述：增强手术培训、规划和导航功能

医学成像、计算机视觉、三维（3D）建模和人工智能（AI）集成技术的最新进展，为神经外科病理解剖生成针对患者的逼真三维可视化铺平了道路。通过增强现实（AR）、虚拟现实（VR）、混合现实（MxR）、扩展现实（XR）和三维打印应用进行的沉浸式手术模拟进一步提高了它们在当前手术实践和培训中的利用率。这篇叙述性综述调查了最先进的研究、这些技术的局限性以及它们在颅底外科领域的未来发展方向。我们首先总结了一种方法，通过结合几种成像模式，为每位患者量身定制精确的三维模型。然后，我们探讨了在涉及前、中、后颅颅底的外科手术（包括内窥镜和开放式显微外科手术）中，如何将这些模型应用于手术规划模拟和实时导航系统。我们还评估了它们对手术决策、性能和教育的影响。不断积累的证据表明，这些技术可以提高位于颅底的神经解剖结构的可见度，协助外科医生进行术前规划和术中导航，从而在改善手术效果和减少并发症方面显示出巨大的潜力。在方法选择、患者定位、开颅手术位置、反目标回避和理解神经血管结构的空间相互关系等方面都能取得最大效果。最后，我们介绍了在神经外科中更广泛地应用这些突破性方法所面临的障碍和未来可能的道路，强调了持续的技术进步和跨学科合作对于提高三维可视化和现实技术在颅底手术中的准确性和实用性的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.