Abstract
Purpose
Cranial nerve microvascular decompression is a habitual neurosurgical procedure. Authors describe a new application of the Dextroscope® (Volume Interactions, Ltd.), a virtual reality environment, to plan and properly simulate this kind of procedures.
Methods
In three cases of hemifacial spasm refractory to drugs and botulinum toxin treatment, the authors used a virtual reality workstation (Dextroscope®) to develop an interactive simulation of craniotomy, approach, and Gore-Tex® implant optimal size and position in order to reach vascular decompression of facial nerve.
Results
Three-dimensional interactive environment allowed the authors to virtually carry out craniotomy, to visualize vascular and nerve relationship, and finally, to select and to simulate best Gore-Tex® graft positioning in each case. During surgical procedures, facial nerve vascular compressions were exposed and Gore-Tex® grafts were successfully placed as it was virtually planned. Patient outcomes were excellent, with an average improvement of two units (0–4 grades of severity scale).
Conclusion
Virtual reality environment can help the neurosurgeon to plan and train vascular decompression procedures. Use of appropriate craniotomy, knowledge of vascular and nerve relationship, and selection of optimum paddy size and position are the main useful applications of the Dextroscope® in these procedures.
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References
Dandy WE (1932) The treatment of trigeminal neuralgia by the cerebellar route. Ann Surg 96:787–795
Gardner WJ, Miklos MV (1957) Response of trigeminal neuralgia to decompression of sensory root; discussion of cause of trigeminal neuralgia. J Am Med Assoc 8;170(15):1773–1776
Gardner WJ (1960) Five-year cure of hemifacial spasm. Report of a case. Cleve Clin Q 27:219–221
Jannetta PJ (1967) Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J Neurosurg 26(Suppl):159–162
Kockro RA, Serra L, Tseng-Tsai Y, Chan C, Yih-Yian S, Gim-Guan C, Lee E, Hoe LY, Hern N, Nowinski WL (2000) Planning and simulation of neurosurgery in a virtual reality environment. Neurosurgery 46:118–135 discussion 135-117
Naraghi R, Tanrikulu L, Troescher-Weber R, Bischoff B, Hecht M, Buchfelder M, Hastreiter P (2007) Classification of neurovascular compression in typical hemifacial spasm: three-dimensional visualization of the facial and the vestibulocochlear nerves. J Neurosurg 107:1154–1163
Stadie AT, Kockro RA, Reisch R, Tropine A, Boor S, Stoeter P, Perneczky A (2008) Virtual reality system for planning minimally invasive neurosurgery. Technical note. J Neurosurg 108:382–394
Wong GK, Zhu CX, Ahuja AT, Poon WS (2007) Craniotomy and clipping of intracranial aneurysm in a stereoscopic virtual reality environment. Neurosurgery 61:564–568 discussion 568-569
Wong GK, Zhu CX, Ahuja AT, Poon WS (2009) Stereoscopic virtual reality simulation for microsurgical excision of cerebral arteriovenous malformation: case illustrations. Surg. Neurol. 72(1):69–72 discussion 72-3
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González Sánchez, J.J., Enseñat Nora, J., Candela Canto, S. et al. New stereoscopic virtual reality system application to cranial nerve microvascular decompression. Acta Neurochir 152, 355–360 (2010). https://doi.org/10.1007/s00701-009-0569-x
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DOI: https://doi.org/10.1007/s00701-009-0569-x