Umana Giuseppe Emmanuele, Ranganathan Sruthi, Marrone Salvatore, Naimo Jessica, Giunta Matteo, Spitaleri Angelo, Fricia Marco, Ferini Gianluca, Scalia Gianluca
Department of Neurosurgery, Trauma and Gamma Knife Center, Cannizzaro Hospital, 95126 Catania, Italy.
School of Medicine and Surgery, Kore University of Enna, 94100 Enna, Italy.
Brain Sci. 2025 Apr 20;15(4):420. doi: 10.3390/brainsci15040420.
One-step cranioplasty combined with tumor removal is a recognized approach in neuro-oncology for patients with neoplastic skull invasion. The use of advanced technologies, including Mixed Reality (MR), has introduced new possibilities in surgical workflows. MR technology may provide additional benefits in preoperative planning, patient engagement, and intraoperative guidance. Can the proposed treatment algorithm, which includes Mixed Reality (MR) for preoperative planning and intraoperative navigation, demonstrate tangible utility and improve outcomes in the surgical management of skull-invasive tumors? A retrospective study was conducted on 14 patients treated at Cannizzaro Hospital, Catania, Italy, for skull-invasive tumors. The treatment algorithm incorporated tumor removal and one-step cranioplasty using custom-made titanium alloy meshes. Standard intraoperative navigation was compared with MR-based navigation. MR headsets and the Virtual Surgery Intelligence (VSI) platform were employed for preoperative planning, surgical guidance, and patient/family communication. Tumor types included nine meningiomas and five other tumor variants. The integration of MR proved beneficial for preoperative planning, facilitating enhanced visualization of patient anatomy and aiding communication with patients and families. MR-assisted intraoperative navigation offered improved anatomical familiarity but demonstrated slightly lower accuracy compared with standard navigation. Postoperative outcomes were satisfactory across the cohort, with no significant complications reported. The study highlights the potential utility of the proposed treatment algorithm including MR technology in the surgical management of skull-invasive tumors. While MR provides enhanced visualization and preoperative engagement, standard navigation remains more precise during surgery. Nevertheless, MR serves as a valuable complementary tool, and its role in neuro-oncological workflows is expected to grow with technological advancements.
一期颅骨成形术联合肿瘤切除是神经肿瘤学中针对肿瘤侵犯颅骨患者的一种公认方法。包括混合现实(MR)在内的先进技术的应用为手术流程带来了新的可能性。MR技术可能在术前规划、患者参与度和术中引导方面提供额外益处。所提出的治疗算法,包括用于术前规划和术中导航的混合现实(MR),能否在颅骨侵犯性肿瘤的手术管理中展现切实效用并改善治疗结果?对意大利卡塔尼亚坎尼扎罗医院治疗的14例颅骨侵犯性肿瘤患者进行了一项回顾性研究。治疗算法包括肿瘤切除和使用定制钛合金网片的一期颅骨成形术。将标准术中导航与基于MR的导航进行比较。使用MR头戴设备和虚拟手术智能(VSI)平台进行术前规划、手术引导以及与患者/家属沟通。肿瘤类型包括9例脑膜瘤和5例其他肿瘤变体。MR的整合被证明对术前规划有益,有助于增强对患者解剖结构的可视化,并有助于与患者及其家属沟通。MR辅助的术中导航提高了对解剖结构的熟悉程度,但与标准导航相比准确性略低。整个队列的术后结果令人满意,未报告重大并发症。该研究强调了所提出的包括MR技术的治疗算法在颅骨侵犯性肿瘤手术管理中的潜在效用。虽然MR提供了增强的可视化和术前参与度,但标准导航在手术期间仍然更精确。尽管如此,MR是一种有价值的辅助工具,随着技术进步,其在神经肿瘤学工作流程中的作用有望扩大。
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