Microscope-based augmented reality assistance in keyhole retrosigmoid approach for microvascular decompression: a technical note - 27/03/26
Highlights |
• | MAR guidance is feasible and easy to implement during keyhole retrosigmoid approach for MVD. |
• | MAR guidance may enhance safety during craniotomy planning, cerebellar retractor placement and arachnoid dissection. |
• | Preoperative 3D segmentation for the preparation of MAR may boost surgeon’s understanding and precision during MVD. |
Abstract |
Background |
The keyhole retrosigmoid approach for microvascular decompression (MVD) demands a high level of microsurgical precision. To improve procedural safety and accuracy, we evaluated the integration of microscope-based augmented reality (MAR) guidance into this approach.
Methods |
Three patients with classical trigeminal neuralgia and a clearly identifiable neurovascular conflict were included. Anatomical segmentations were performed using Brainlab Elements software (Brainlab AG, Munich, Germany), employing both automatic and semi-automatic tools. Intraoperatively, the Zeiss Kinevo 900 microscope (Carl Zeiss AG, Oberkochen, Germany), integrated with MAR navigation, was used. The system’s reliability and usefulness were evaluated while performing MVD through the keyhole retrosigmoid approach.
Results |
MAR guidance improved surgical confidence and precision during craniotomy and cerebellar retractor placement. The integration of MAR proved reliable and easy to use intraoperatively.
Conclusions |
MAR-assisted MVD via a keyhole retrosigmoid approach is feasible, straightforward to implement, and provides valuable intraoperative guidance. MAR may enhance procedural safety and confidence during MVD for trigeminal neuralgia.
Le texte complet de cet article est disponible en PDF.Keywords : Microvascular decompression, Trigeminal neuralgia, Augmented reality, 3D anatomy, Keyhole retrosigmoid approach
Plan
Vol 72 - N° 3
Article 101806- mai 2026 Retour au numéro
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