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Skull Base 2006; 16(2): 059-066
DOI: 10.1055/s-2006-931620
ORIGINAL ARTICLE

Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Virtual Reality Augmentation in Skull Base Surgery

Steffen K. Rosahl1 , Alireza Gharabaghi2 , Ulrich Hubbe1 , Ramin Shahidi3 , Madjid Samii4
  • 1Department of Neurosurgery, University of, Freiburg, Germany
  • 2Department of Neurosurgery, University Hospital, Tüebingen, Germany
  • 3Image Guidance Laboratories, Stanford University, Palo Alto, California
  • 4International Neuroscience Institute (INI), Hannover, Germany
Further Information

Publication History

Publication Date:
14 February 2006 (online)

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ABSTRACT

Objective: Skull base anatomy is complex and subject to individual variation. Understanding the complexity of surgical anatomy is faster and easier with virtual models created from primary imaging data of the patient. This study was designed to investigate the usefulness of virtual reality in image guidance for skull base procedures. Design: Primary volumetric image data from 110 patients was acquired using magnetic resonance, computed tomography (CT), and CT angiography. Pathologies included lesions in the anterior, middle, and posterior skull base. The data were transferred to an infrared-based image-guidance system for creation of a virtual operating field (VOF) with translucent surface modulation and optional “fly-through” video mode. During surgery, the target registration error for anatomical landmarks was assessed and the VOF was compared with the patient's anatomy in the operative field. Results: Complex structures like the course of the sigmoid sinus, the carotid artery, and the outline of the paranasal sinuses were well visualized in the VOF and were recognized by the surgeon instantly. Perception was greatly facilitated as compared with routine mental reconstruction of triaxial images. Accurate assessment of the depth of field and very small objects was not possible in VOF images. Conclusion: Supported by sound anatomical knowledge, creation of a virtual operating field for a surgical approach in an individual patient offers a déjà vu experience that can enhance the capabilities of a surgical team in skull base approaches. In addition, application of this technique in image-guided procedures assists in targeting or avoiding hidden anatomical structures.

KEYWORDS

Three-dimensional image guidance - virtual reality - skull base approaches

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Steffen K RosahlM.D. 

Department of Neurosurgery, University of Freiburg

Breisacher Str. 64, D-79106, Freiburg, Germany