Division of Neurosurgery, Santa Marcelina Hospital, São Paulo, São Paulo, Brazil; Scientific Board, EDUCSIM Institute, São Paulo, São Paulo, Brazil; Division of Neurosurgery, São Paulo University, USP, São Paulo, São Paulo, Brazil; Division of Craniofacial Surgery, Sabará Children's Hospital, São Paulo, São Paulo, Brazil.
Division of Neurosurgery, Santa Marcelina Hospital, São Paulo, São Paulo, Brazil; Division of Neurosurgery, São Paulo University, USP, São Paulo, São Paulo, Brazil; Division of Craniofacial Surgery, Sabará Children's Hospital, São Paulo, São Paulo, Brazil.
World Neurosurg. 2021 Jul;151:124-131. doi: 10.1016/j.wneu.2021.04.132. Epub 2021 May 5.
Late surgical correction of meningoencephalocele is a rare scenario that remains challenging for surgeons. Three-dimensional models can mimic the correct anatomical relationships, and technological systems have brought advances to medicine. This study aims to present a novel preoperative planning modality that combines augmented reality with a hybrid model for complex malformation associated with late correction.
The present report describes a case of frontoethmoidal encephalocele of a 10-year-old girl. Two different methods for planning the approach were developed: 1) a hybrid hands-on model and 2) augmented reality, using a cell phone app and headset display. The customized hybrid model was created based on patient's imaging. The augmented reality app was developed with a real-time interface.
The hybrid model recreated anatomic alterations, thereby allowing a multidisciplinary team to determine an appropriate surgical approach. All aspects of the surgical procedure were simulated. A pre- to postoperative comparison was made, which emphasized benefit of tridimensional anatomical relationships using augmented reality tool and its role in preoperative planning.
The authors believe this new multimodality preoperative platform could be a useful method to improve multidisciplinary discussion as well as a powerful tool for teaching and planning.
脑膜脑膨出的晚期手术矫正较为罕见,对外科医生来说仍然具有挑战性。三维模型可以模拟正确的解剖关系,而技术系统也为医学带来了进步。本研究旨在提出一种新的术前规划方式,将增强现实与混合模型相结合,用于矫正复杂畸形。
本报告介绍了一例 10 岁女孩额筛脑膨出病例。为规划手术入路开发了两种不同的方法:1)混合实物模型,2)使用手机应用程序和头戴式显示器的增强现实。定制的混合模型是基于患者的影像学创建的。增强现实应用程序采用实时接口开发。
混合模型再现了解剖结构的改变,从而使多学科团队能够确定合适的手术入路。模拟了手术过程的所有方面。进行了术前至术后的比较,强调了使用增强现实工具的三维解剖关系的益处,以及其在术前规划中的作用。
作者认为,这种新的多模态术前平台可以作为一种有用的方法,以改善多学科讨论,也是教学和规划的有力工具。