1Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine in Neurologic Surgery, Neurosurgical Clinic, AOUP "Paolo Giaccone," University of Palermo; and.
2Department of Head and Neck Surgery, Neurosurgery Unit, Garibaldi Hospital, Catania, Italy.
Neurosurg Focus. 2024 Jan;56(1):E16. doi: 10.3171/2023.10.FOCUS23601.
The surgical approach to lesions near eloquent areas continues to represent a challenge for neurosurgeons, despite all of the sophisticated tools currently used. The goal of surgery in eloquent areas is to maintain a good oncofunctional balance, that is, to preserve neurological function and ensure maximum tumor resection. Among all the available tools, extended reality (used to describe both virtual reality [VR] and mixed reality) is rapidly gaining a pivotal role in such delicate lesions, especially in preoperative planning, and recently, even during the surgical procedure. VR creates a completely new world in which only digital components are present. Augmented reality (AR), using software and hardware to introduce digital elements into the real-world environment, enhances the human experience. In addition, mixed reality, a more recent technique, combines VR and AR by projecting virtual objects into the real world, allowing the user to interact with them.
A systematic literature review of the last 23.5 years was conducted (January 2000-June 2023) to investigate and discuss all progress related to the emerging role and use of these new technologies (VR, AR, and mixed reality), particularly in eloquent area lesions as a pre- and/or intraoperative tool.
Five hundred eighty-four published studies were identified. After removing duplicates and excluding articles that did not meet the inclusion criteria, 21 papers were included in the systematic review. The use of AR or VR was fully analyzed, considering their roles both intraoperatively and for surgical planning.
The increasing use of such innovative technologies has completely changed the way to approach a lesion, using 3D visualization to foster a better understanding of its anatomical and vascular characteristics.
尽管目前有许多复杂的工具，但对于神经外科医生来说，临近语言功能区的病变的手术入路仍然是一个挑战。在语言功能区进行手术的目的是保持良好的肿瘤功能平衡，也就是说，既要保留神经功能，又要确保最大限度地切除肿瘤。在所有可用的工具中，扩展现实（用于描述虚拟现实 [VR] 和混合现实）在这些精细病变的术前规划中迅速发挥着关键作用，最近甚至在手术过程中也发挥着关键作用。VR 创造了一个全新的世界，其中只有数字组件。增强现实（AR）使用软件和硬件将数字元素引入现实环境，增强了人类的体验。此外，混合现实是一种更近期的技术，通过将虚拟物体投影到现实世界中，将 VR 和 AR 结合起来，允许用户与之交互。
对过去 23.5 年（2000 年 1 月至 2023 年 6 月）的文献进行了系统回顾，以调查和讨论与这些新技术（VR、AR 和混合现实）的新兴作用和用途相关的所有进展，特别是作为术前和/或术中工具在语言功能区病变中的应用。
共确定了 584 篇已发表的研究。在去除重复项并排除不符合纳入标准的文章后，有 21 篇文章被纳入系统评价。对 AR 或 VR 的使用进行了全面分析，考虑了它们在手术中和手术规划中的作用。
这些创新技术的应用越来越广泛，彻底改变了接近病变的方式，使用 3D 可视化来促进对其解剖和血管特征的更好理解。
