Department of Otolaryngology-Head and Neck Surgery and Communication Enhancement Center, Chang Gung Memorial Hospital and Chang Gung University.
Department of Otolaryngology-Head and Neck Surgery, Mackay Memorial Hospital; Department of Audiology and Speech Language Pathology, Mackay Medical College;
J Vis Exp. 2021 Jul 28(173). doi: 10.3791/60069.
A 2D monocular endoscope has been used in transcanal transpromontory vestibular schwannoma surgery instead of craniotomy. However, the absence of depth perception is the limitation of this approach. With the loss of depth perception, the surgeon will be not able to perform delicate and particularly complicated surgery. A binocular endoscope has been developed to provide stereoscopic vision with better depth perception for complicated anatomic structures and has been applied in some endoscopic surgeries. However, the diameter of the endoscope is a limitation in the performance of transcanal otologic surgeries. A small diameter endoscope facilitates easier surgery in a restricted space. A computer-based 3D imaging system can obtain 3D images in real-time using a small monocular endoscope. In this study, to evaluate the feasibility of a computer-based 3D imaging system for endoscopic lateral skull base surgery, we applied this 3D imaging system in a transcanal transpromontorial approach in two patients with vestibular schwannomas. The surgical procedure was completed without complication in these two cases. There was no mortality, perioperative complications, nor notable postoperative complications. Using this computer-based 3D imaging system, a better depth perception and stereoscopic vision was observed compared to a conventional 2D endoscope. The improvement in depth perception offers superior management of the complicated surgical anatomy.
已经使用二维单目内窥镜替代开颅经颅后窝入路听神经瘤切除术。然而，这种方法的局限性在于缺乏深度感知。由于深度感知的丧失，外科医生将无法进行精细和特别复杂的手术。已经开发出双目内窥镜来为复杂的解剖结构提供立体视觉和更好的深度感知，并已应用于一些内窥镜手术中。然而，内窥镜的直径是经耳道耳科手术性能的限制。小直径的内窥镜可在有限的空间内更容易进行手术。基于计算机的 3D 成像系统可以使用小型单目内窥镜实时获得 3D 图像。在这项研究中，为了评估基于计算机的 3D 成像系统在经耳道颅底外侧内窥镜手术中的可行性，我们在两名前庭神经鞘瘤患者中应用了该 3D 成像系统进行经耳道经后颅窝入路手术。这两例手术均无并发症完成。无死亡、围手术期并发症或明显术后并发症。与传统的 2D 内窥镜相比，使用这种基于计算机的 3D 成像系统可以观察到更好的深度感知和立体视觉。深度感知的提高提供了对复杂手术解剖结构的更好管理。
