Commentary: Application of Augmented Reality in Percutaneous Procedures—Rhizotomy of the Gasserian Ganglion

Application of Augmented Reality in Percutaneous Procedures—Rhizotomy of the Gasserian Ganglion

Operative Neurosurgery ◽

10.1093/ons/opab155 ◽

2021 ◽

Author(s):

Alexander Rau ◽

Roland Roelz ◽

Horst Urbach ◽

Volker Arnd Coenen ◽

Theo Demerath ◽

...

Keyword(s):

Augmented Reality ◽

Euclidean Distance ◽

Three Dimensional ◽

Target Point ◽

Gasserian Ganglion ◽

Foramen Ovale ◽

Lateral Deviation ◽

Percutaneous Procedures ◽

Percutaneous Rhizotomy ◽

Improved Accuracy

Abstract BACKGROUND Percutaneous rhizotomy of the Gasserian ganglion for trigeminal neuralgia is an effective therapeutic procedure. Yet, landmark-guided cannulation of the foramen ovale is manually challenging and difficult to learn. OBJECTIVE To overcome these limitations, we assessed the feasibility and accuracy of an augmented reality (AR)-guided puncture of the foramen ovale. METHODS A head phantom with soft tissue structures of the facial area was built. A three-dimensional (3D)-dataset of the phantom was generated using a stereotactic planning workstation. An optimal trajectory to the foramen ovale was created and then transferred to an AR headset. A total of 2 neurosurgeons and 2 neuroradiologists independently performed 8 AR-guided and 8 landmark-guided cannulations of the foramen ovale, respectively. For each AR-guided cannulation, the hologram was manually aligned with the phantom. Accuracy of the cannulation was evaluated using the Euclidean distance to the target point as well as the lateral deviation of the achieved trajectory from the planned trajectory at target point level. RESULTS With the help of AR guidance, a successful cannulation of the foramen ovale was achieved in 90.6% compared to the purely landmark-based method with 18.8%. Euclidean distance and lateral deviation were significantly lower with AR guidance than landmark guidance (P < .01). CONCLUSION AR greatly improved accuracy of simulated percutaneous rhizotomy of the Gasserian ganglion.

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Application of a New Wearable Augmented Reality Video See-Through Display to Aid Percutaneous Procedures in Spine Surgery

Lecture Notes in Computer Science - Augmented Reality, Virtual Reality, and Computer Graphics ◽

10.1007/978-3-319-40651-0_4 ◽

2016 ◽

pp. 43-54 ◽

Cited By ~ 14

Author(s):

Fabrizio Cutolo ◽

Marina Carbone ◽

Paolo D. Parchi ◽

Vincenzo Ferrari ◽

Michele Lisanti ◽

...

Keyword(s):

Augmented Reality ◽

Spine Surgery ◽

Percutaneous Procedures ◽

Wearable Augmented Reality

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Improved visualization of the foramen ovale for percutaneous approaches to the gasserian ganglion

Journal of Neurosurgery ◽

10.3171/jns.1994.80.1.0156 ◽

1994 ◽

Vol 80 (1) ◽

pp. 156-159 ◽

Cited By ~ 22

Author(s):

Arthur M. Gerber

Keyword(s):

Trigeminal Neuralgia ◽

Radiation Exposure ◽

Gasserian Ganglion ◽

Foramen Ovale ◽

Content Type ◽

Percutaneous Procedures ◽

Radiopaque Markers ◽

Radiological Studies ◽

Fine Print

✓ Percutaneous procedures for treating trigeminal neuralgia involve the penetration of foramen ovale using cutaneous landmarks and radiological guidance. The placement of radiopaque markers over the commonly used “zygomatic points” in front of the ears provides landmarks on intraoperative radiological studies that facilitate localization of the foramen ovale. Speed and safety of percutaneous trigeminal procedures should be enhanced. There is no increase in radiation exposure over that in other commonly used approaches.

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Impact of an Augmented Reality Navigation System (SIRIO) on Bone Percutaneous Procedures: A Comparative Analysis with Standard CT-Guided Technique

Current Oncology ◽

10.3390/curroncol28030163 ◽

2021 ◽

Vol 28 (3) ◽

pp. 1751-1760

Author(s):

Eliodoro Faiella ◽

Gennaro Castiello ◽

Caterina Bernetti ◽

Giuseppina Pacella ◽

Carlo Altomare ◽

...

Keyword(s):

Augmented Reality ◽

Radiation Dose ◽

Diagnostic Accuracy ◽

Navigation System ◽

Ct Scans ◽

Bone Lesions ◽

Ct Guided ◽

Percutaneous Procedures ◽

Procedural Time ◽

Ablative Procedures

(1) Background: The purpose of this study is to evaluate the impact of an augmented reality navigation system (SIRIO) for percutaneous biopsies and ablative treatments on bone lesions, compared to a standard CT-guided technique. (2) Methods: Bioptic and ablative procedures on bone lesions were retrospectively analyzed. All procedures were divided into SIRIO and Non-SIRIO groups and in <2 cm and >2 cm groups. Number of CT-scans, procedural time and patient’s radiation dose were reported for each group. Diagnostic accuracy was obtained for bioptic procedures. (3) Results: One-hundred-ninety-three procedures were evaluated: 142 biopsies and 51 ablations. Seventy-four biopsy procedures were performed using SIRIO and 68 under standard CT-guidance; 27 ablative procedures were performed using SIRIO and 24 under standard CT-guidance. A statistically significant reduction in the number of CT-scans, procedural time and radiation dose was observed for percutaneous procedures performed using SIRIO, in both <2 cm and >2 cm groups. The greatest difference in all variables examined was found for procedures performed on lesions <2 cm. Higher diagnostic accuracy was found for all SIRIO-assisted biopsies. No major or minor complications occurred in any procedures. (4) Conclusions: The use of SIRIO significantly reduces the number of CT-scans, procedural time and patient’s radiation dose in CT-guided percutaneous bone procedures, particularly for lesions <2 cm. An improvement in diagnostic accuracy was also achieved in SIRIO-assisted biopsies.

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Treatment of Trigeminal Neuralgia by Thermocoagulation, Glycerolization, and Percutaneous Compression of the Gasserian Ganglion and/or Retrogasserian Rootlets: Long-Term Results and Therapeutic Protocol

Neurosurgery ◽

10.1227/00006123-198902000-00014 ◽

1989 ◽

Vol 24 (2) ◽

pp. 239-245 ◽

Cited By ~ 104

Author(s):

Bernardo Fraioli ◽

Vincenzo Esposito ◽

Beniamino Guidetti ◽

Giorgio Cruccu ◽

Mario Manfredi

Keyword(s):

Multiple Sclerosis ◽

Trigeminal Neuralgia ◽

Open Surgery ◽

Balloon Catheter ◽

Long Term Results ◽

Gasserian Ganglion ◽

Percutaneous Procedures ◽

Therapeutic Protocol

Abstract From 1976 to 1986, 681 patients with drug-refractory trigeminal neuralgia (TN)—typical in 641, symptomatic of multiple sclerosis in 23 and of tumor in 10, atypical in 5, and postherpetic in 2—were treated with various percutaneous procedures. Controlled differential thermocoagulation of the gasserian ganglion and/or retrogasserian rootlets was performed in 533 patients; glycerolization of the trigeminal cistern in 32; and compression of the gasserian ganglion by balloon catheter in 159, Results and complications of each procedure are assessed at a mean follow-up of 6.5 years for thermocoagulation, 5 years for glycerolization, and 3.5 years for compression. The following therapeutic protocol is proposed: 1) in TN patients at first operation: a) gasserian compression (or glycerolization, if experience warrants it) is indicated in all cases of typical TN, unless the 3rd division alone is affected; b) in the latter case and in symptomatic TN, we suggest thermocoagulation; 2) in recurrences: a) after glycerolization or gasserian compression, gasserian compression (or glycerolization) is indicated; b) after thermocoagulation or open surgery, thermocoagulation is suggested.

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