Abstract:

Objective: To summarize the clinical experience of supratentorial tumor resection using a wireless head - mounted display (HMD) - based holographic mixed reality navigation system (MRN). Methods: A analysis was performed on 5 patients undergoing supratentorial tumor resection using holographic MRN at Zhuhai People's Hospital from March to September 2024. Preoperative imaging data were imported into 3D Slicer software to generate holograms of lesions, anatomical landmarks, and adjacent structures, which were subsequently integrated into the holographic MRN and projected onto the patient's head for preoperative incision planning and intraoperative tumor resection guidance. The convenience and stability of holographic MRN were evaluated by assessing navigation registration time, navigation application time, and registration attempts. Accuracy, efficacy, and safety of holographic MRN were analyzed through evaluation of bone window extent, tumor - to - surrounding structure relationships, modeling time tumor localization, Karnofsky Performance Status (KPS) scores, and surgical indicators. Results: Preoperative modeling was all successfully completed, with an average modeling time (25.20 ± 1.60) min, and average registration time (3.20 ± 0.05) min. The mean preoperative and intraoperative navigation application times were (12.74 ± 1.09) and (8.17 ± 0.81) min, respectively. All registrations were successful on the first attempt. All lesions were entirely within the planned bone window boundaries, with no under - or over - exposure. Holographic projections of tumors fully overlapped with actual intraoperative lesions. All 5 cases achieved Simpson grade Ⅰ resection. The average KPS score at 72 h after surgery was 94.00 ± 4.90. Conclusions: This study confirms the convenience, stability, accuracy, efficacy, and safety of holographic MRN in clinical practice, demonstrating its value as an adjunctive tool for supratentorial tumor craniotomy.

Key words: Supratentorial neoplasms, Mixed reality (not in MeSH), Neuronavigation, Microsurgery

摘要：

目的: 总结混合现实神经导航系统辅助幕上肿瘤切除术的临床经验。方法: 病例为2024年3-9月在广东省珠海市人民医院接受全息混合现实神经导航系统辅助幕上肿瘤切除术的患者共5例。术前影像学数据导入3D Slicer软件并生成肿瘤灶、解剖标志和邻近结构的全息图像，导入全息混合现实神经导航系统同时投影至患者头部，进行术前手术切口规划并指导术中肿瘤切除；通过评估导航注册时间、导航应用时间和配准次数分析该系统的便捷性和稳定性；评估骨窗范围、肿瘤灶与全息图像重叠效果、建模时间、肿瘤定位的应用价值、Karnofsky功能状态评分(KPS)及手术相关指标分析该系统的精准性、快速性和安全性。结果: 共5例患者均成功完成术前建模，平均建模时间(25.20 ± 1.60)min，注册时间(3.20 ± 0.05)min，术前导航应用时间(12.74 ± 1.09)min，术中导航应用时间(8.17 ± 0.81)min，所有患者均1次配准成功，肿瘤均位于骨窗范围内，骨窗显露良好。全息投影定位的肿瘤与术中所见完全重叠，肿瘤切除分级均达SimpsonⅠ级切除，术后72 h KPS评分(94.00 ± 4.90)分。结论: 全息混合现实神经导航系统用于神经外科手术便捷性、稳定性、精准性、快速性和安全性良好，可为幕上肿瘤开颅手术提供帮助，值得推荐。

关键词: 幕上肿瘤, 混合现实(非MeSH词), 神经导航, 显微外科手术