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

Author

Listed:
  • Nicola Montemurro

    (Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), University of Pisa, 56100 Pisa, Italy)

  • Sara Condino

    (Department of Information Engineering, University of Pisa, 56100 Pisa, Italy
    EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy)

  • Nadia Cattari

    (EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy
    Department of Translational Research, University of Pisa, 56100 Pisa, Italy)

  • Renzo D’Amato

    (Department of Information Engineering, University of Pisa, 56100 Pisa, Italy
    EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy)

  • Vincenzo Ferrari

    (Department of Information Engineering, University of Pisa, 56100 Pisa, Italy
    EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy)

  • Fabrizio Cutolo

    (Department of Information Engineering, University of Pisa, 56100 Pisa, Italy
    EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy)

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.

Suggested Citation

  • Nicola Montemurro & Sara Condino & Nadia Cattari & Renzo D’Amato & Vincenzo Ferrari & Fabrizio Cutolo, 2021. "Augmented Reality-Assisted Craniotomy for Parasagittal and Convexity En Plaque Meningiomas and Custom-Made Cranio-Plasty: A Preliminary Laboratory Report," IJERPH, MDPI, vol. 18(19), pages 1-13, September.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:19:p:9955-:d:640466
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    References listed on IDEAS

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    1. Nicola Montemurro & Paolo Perrini & Biagio Rapone, 2020. "Clinical Risk and Overall Survival in Patients with Diabetes Mellitus, Hyperglycemia and Glioblastoma Multiforme. A Review of the Current Literature," IJERPH, MDPI, vol. 17(22), pages 1-18, November.
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    Cited by:

    1. Ae-Ri Jung & Eun-A Park, 2022. "The Effectiveness of Learning to Use HMD-Based VR Technologies on Nursing Students: Chemoport Insertion Surgery," IJERPH, MDPI, vol. 19(8), pages 1-11, April.
    2. Nicola Montemurro & Sara Condino & Marina Carbone & Nadia Cattari & Renzo D’Amato & Fabrizio Cutolo & Vincenzo Ferrari, 2022. "Brain Tumor and Augmented Reality: New Technologies for the Future," IJERPH, MDPI, vol. 19(10), pages 1-3, May.
    3. Rakesh Mishra & M.D. Krishna Narayanan & Giuseppe E. Umana & Nicola Montemurro & Bipin Chaurasia & Harsh Deora, 2022. "Virtual Reality in Neurosurgery: Beyond Neurosurgical Planning," IJERPH, MDPI, vol. 19(3), pages 1-14, February.

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