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Tzelnick S, Rampinelli V, Sahovaler A, Franz L, Chan HHL, Daly MJ, Irish JC. Skull-Base Surgery—A Narrative Review on Current Approaches and Future Developments in Surgical Navigation. J Clin Med 2023; 12:jcm12072706. [PMID: 37048788 PMCID: PMC10095207 DOI: 10.3390/jcm12072706] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/10/2023] [Accepted: 03/29/2023] [Indexed: 04/07/2023] Open
Abstract
Surgical navigation technology combines patient imaging studies with intraoperative real-time data to improve surgical precision and patient outcomes. The navigation workflow can also include preoperative planning, which can reliably simulate the intended resection and reconstruction. The advantage of this approach in skull-base surgery is that it guides access into a complex three-dimensional area and orients tumors intraoperatively with regard to critical structures, such as the orbit, carotid artery and brain. This enhances a surgeon’s capabilities to preserve normal anatomy while resecting tumors with adequate margins. The aim of this narrative review is to outline the state of the art and the future directions of surgical navigation in the skull base, focusing on the advantages and pitfalls of this technique. We will also present our group experience in this field, within the frame of the current research trends.
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Affiliation(s)
- Sharon Tzelnick
- Division of Head and Neck Surgery, Princess Margaret Cancer Center, University of Toronto, Toronto, ON M5G 2M9, Canada
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
- Technology for Health (PhD Program), Department of Information Engineering, University of Brescia, 25121 Brescia, Italy
| | - Axel Sahovaler
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, Toronto, ON M5G 2C4, Canada
- Head & Neck Surgery Unit, University College London Hospitals, London NW1 2PG, UK
| | - Leonardo Franz
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, 35122 Padua, Italy
| | - Harley H. L. Chan
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Michael J. Daly
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Jonathan C. Irish
- Division of Head and Neck Surgery, Princess Margaret Cancer Center, University of Toronto, Toronto, ON M5G 2M9, Canada
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, Toronto, ON M5G 2C4, Canada
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Cannizzaro D, Zaed I, Safa A, Jelmoni AJM, Composto A, Bisoglio A, Schmeizer K, Becker AC, Pizzi A, Cardia A, Servadei F. Augmented Reality in Neurosurgery, State of Art and Future Projections. A Systematic Review. Front Surg 2022; 9:864792. [PMID: 35360432 PMCID: PMC8961734 DOI: 10.3389/fsurg.2022.864792] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/11/2022] [Indexed: 01/13/2023] Open
Abstract
Background The use of augmented reality (AR) is growing in medical education, in particular, in radiology and surgery. AR has the potential to become a strategic component of neurosurgical training courses. In fact, over the years, there has been a progressive increase in the application of AR in the various fields of neurosurgery. In this study, the authors aim to define the diffusion of these augmented reality systems in recent years. This study describes future trends in augmented reality for neurosurgeons. Methods A systematic review of the literature was conducted to identify research published from December 1st, 2011 to November 30th, 2021. Electronic databases (PubMed, PubMed Central, and Scopus) were screened. The methodological quality of studies and extracted data were assessed for “augmented reality” and “neurosurgery”. The data analysis focused on the geographical distribution, temporal evolution, and topic of augmented reality in neurosurgery. Results A total of 198 studies have been included. The number of augmented reality applications in the neurosurgical field has increased during the last 10 years. The main topics on which it is mostly applied are spine surgery, neuronavigation, and education. The geographical distribution shows extensive use of augmented reality in the USA, Germany, China, and Canada. North America is the continent that uses augmented reality the most in the training and education of medical students, residents, and surgeons, besides giving the greatest research contribution in spine surgery, brain oncology, and surgical planning. AR is also extensively used in Asia for intraoperative navigation. Nevertheless, augmented reality is still far from reaching Africa and other countries with limited facilities, as no publications could be retrieved from our search. Conclusions The use of AR is significantly increased in the last 10 years. Nowadays it is mainly used in spine surgery and for neurosurgical education, especially in North America, Europe and China. A continuous growth, also in other aspects of the specialty, is expected in the next future.
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Affiliation(s)
- Delia Cannizzaro
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Ismail Zaed
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- *Correspondence: Ismail Zaed
| | - Adrian Safa
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Alice J. M. Jelmoni
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Antonio Composto
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Andrea Bisoglio
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Kyra Schmeizer
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Ana C. Becker
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Andrea Pizzi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Andrea Cardia
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Franco Servadei
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
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